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methods, tools and technologies
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|
 EORCA
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Event-Oriented Representation of Collaborative Activities |
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| keywords |
clinical domains |
| Clinical guidelines, clinical protocols, collaborative
activity, formal representation, cognitive ergonomics, ontologies, safety,
adverse events |
Intensive Care Units |
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| summary of objectives |
Development
and evaluation of a formal
method for modelling collaborative medical
activities in specialist settings
to support the creation of care team guidelines.
The method
is designed to support the development and validation of
protocols applicable to specialties such as the ICU
where medical decisions are not only taken by
individual physicians but frequently involve
groups of expert physicians acting in complex and
time-constrained situations.
This method is also designed to support the identification of clinical adverse events, such as potential incidents and near miss events during patient management.
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| location |
Marseille, France
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| partners |
Laboratoire d'Informatique Fondamentale
UMR CNRS 6166, Faculté de Médecine,
Marseille, France.
Centre de Recherche en Psychologie de la Connaissance,
du Langage et de l’Emotion, EA 3273,
Université de Provence, Aix-en-Provence,
France.
Département d'Anesthésie-Réanimation
de l'Hôpital Nord, Assistance Publique
- Hôpitaux de Marseille, France.
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| start date |
January 2001
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| end date |
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| support |
Ministère de la Santé,
Programme Hospitalier de Recherche Clinique National
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| description |
Use of clinical guidelines and protocols is
currently not fully integrated into routine medical
activities, even if health organizations
and physicians have widely recognized their potential
for improving the quality of clinical care.
Various attempts have been made to help accelerate the adoption of
clinical
guidelines and protocols in clinical practice and reduce variability in clinical decision-making:
- Computer-based
guideline have been developed (if with limited success)
to facilitate decision support;
- Instruments (such as AGREE and GLIA) have been proposed to ensure guideline quality and
fitness for implementation.
The EORCA project is adopting a different approach to supporting
clinical guideline implementation,
based on a formal task analysis of real medical activities
and modelling observed elements of patient
management.
The project is building a formal method of observation
and an Event Oriented Representation of Collaborative
Activities (EORCA) to describe the actions of team members
during patient management in an
Intensive Care unit. The event-centered
basis of the representation was suggested
by the fact that events constitute the observable
parts of medical activities.
The project aims to develop a method which is
robust and reproducible to allow for
further qualitative and quantitative analysis.
The method is particularly designed to support
the creation and validation of guidelines and
protocols for specialties
where medical decisions are not only made by
individual physicians but also by groups
of expert physicians acting in complex and time-constrained
situations.
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|
| references |
Pellegrin L, Bonnardel
N, DeVictor N, Bastien C, Chaudet H.
Modeling a Cooperative Medical Decision
Making in an Intensive Care Unit. In:
G Van der Veer, J Hoorn, editors, Proceedings
of the 9th European Conference on Cognitive
Science Approaches to Process Control
(CSAPC 2003) : « Cognition
and Collaboration - Distributed Cognition
in Complex Processes »; 16-19
September 2003; Amsterdam, The Netherlands.
EACE and ACM SIGCHI; 2003. p. 105-12.
[]
[paper] |
"This research deals
with modelling the collective decision-making
in a specialised medical situation: the
patient management of multiple trauma
and neurological injuries in an intensive
care unit. Our focus was first upon the
activity of physicians specialized in
intensive care in a French public hospital.
This activity was of special interest
since we hypothesized that it was based
on a supervised collaboration with the
other caregivers, members of the trauma
resuscitation team. Our goal was to build
a method useful for both observing and
representing the collective activity of
management, which should be re-usable
by the team members in order to prepare
themselves to official procedures of accreditation.
The field study presented in this paper
allowed a first finalization of this tool.
It consists of two elements: an observational
method of the medical staff activities
developed upon patient management, and
a specific representational method. This
last one is constituted by an ontology,
which describes both actors and observed
events related to patient management by
a temporal flowchart. The obtained results
allowed us to identify specific features
of this complex and time-constrained situation,
especially about the strong collaborative
activities between members of the patient-care
team." |
Pellegrin L, Bonnardel
N, Antonini F, Albanese J, Martin C,
Chaudet H. EORCA : A Collaborative Activities
Representation for Building Guidelines
from Field Observations. In: S Miksch,
J Hunter, E Keravnou, editors, Artificial
Intelligence in Medicine. 10th Conference
on Artificial Intelligence in Medicine,
AIME 2005, Aberdeen, UK, July 23-27,
2005. Proceedings. Berlin, Deutchland:
Springer-Verlag. Lecture Notes in Computer
Science/ Lecture Notes in Artificial
Intelligence. Vol. 3581. 2005. p 111-20.
[]
[paper - U Marseille]
[AIME presentation]
|
"
In the objective
of building care team guidelines from
field observations, this paper introduces
a representation method for describing
the medical collaborative activities during
an ICU patient management. An event centered
representation of medical activities is
built during a 3-step procedure, successively
involving an event-centered observation
phase, an action extraction and coding
phase, and an event and collaborative
representation phase. This method has
been used for analyzing the management
of 24 cases of neurological and multiple
traumas. We have represented the different
actions of the medical team members (clinicians,
nurses and outside medical consultants),
underlining collaborative information
management and the strong interaction
between information management and medical
actions. This method also highlights the
difficulty of cases management linked
to diagnosis severity, complexity of the
situation and time constraints.
"
|
Pellegrin L, Bonnardel
N, Chaudet H. Event Oriented Representation
for Collaborative Activities in an Intensive
Care Unit. Annual Conference of the
European Association of Cognitive Ergonomics,
2005 (incorporating the 10th Conference
on Cognitive Science Aspects of Process
Control and the 13th European Conference
on Cognitive Ergonomics); Chania, Greece;
29 september - 1 October 2005.
[]
[paper - U Marseille]
|
"
We introduce
in this paper a method for describing
the components of medical activities
during a patient management in an ICU
(Intensive Care Unit) by the medical
team, including physicians and nurses.
This method allows both observing and
representing the collective activity
of patient management and should be
used by the team members in order to
prepare themselves to official accreditation
procedures. An event-centred representation
of medical activities is built during
a 3-steps procedure. It successively
involves an event-centred observation
phase, an action extraction and coding
phase, and an event and collaborative
representation phase. The results allow
us to characterize specific features
of this complex and time-constrained
situation as well as the collaborative
activities between members of the team.
"
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|
|
| contact |
Liliane Pellegrin
liliane.pellegrin medecine.univ-mrs.fr
Hervé Chaudet
herve.chaudetmedecine.univ-mrs.fr
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| links |
|
|
| acknowledgements |
| Liliane Pellegrin, Laboratoire d'Informatique Fondamentale,
Faculté de Médecine, Marseille, France |
| page history |
Entry on OpenClinical: 07 September 2005
Last main update: 27 September 2005
Template v0.3: 25 June 2005. |
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EORCA