Complexity of the pediatric trauma care process: Implications for multi-level awareness.

摘要: Trauma is the leading cause of disability and death in children young adults US. While much known about medical aspects inpatient pediatric trauma care, not processes roles involved in-hospital care. Using human factors engineering (HFE) methods, we combine interview, archival document registry data to describe how intra-hospital care transitions affect process team complexity. Specifically, identify 53 directly patient each hospital unit 3324 total between units 69 unique pathways, from arrival discharge, experienced by patients. We continue argument shift eliminating complexity coping with it propose supporting three levels awareness enhance resilience adaptation necessary for safety health i.e. complex systems. discuss (individual, organizational) challenges potential sociotechnical solutions each. For example, one challenge individual high time pressure. A solution clinical decision support information perception, integration making. inadequate "non-technical" skills, e.g., leadership, communication, role clarity; simulation or another form training could improve these. The complex, distributed nature this a organizational awareness; develop interdependencies within it, using modeling simulation.