More isn't always better: Technology in the intensive care unit

Esther Olsen,Zhanna Novikov, Theadora Sakata, Monique H. Lambert,Javier Lorenzo, Roger Bohn,Sara J. Singer

HEALTH CARE MANAGEMENT REVIEW(2024)

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摘要
BackgroundClinical care in modern intensive care units (ICUs) combines multidisciplinary expertise and a complex array of technologies. These technologies have clearly advanced the ability of clinicians to do more for patients, yet so much equipment also presents the possibility for cognitive overload.PurposeThe aim of this study was to investigate clinicians' experiences with and perceptions of technology in ICUs.Methodology/ApproachWe analyzed qualitative data from 30 interviews with ICU clinicians and frontline managers within four ICUs.ResultsOur interviews identified three main challenges associated with technology in the ICU: (a) too many technologies and too much data; (b) inconsistent and inaccurate technologies; and (c) not enough integration among technologies, alignment with clinical workflows, and support for clinician identities. To address these challenges, interviewees highlighted mitigation strategies to address both social and technical systems and to achieve joint optimization.ConclusionWhen new technologies are added to the ICU, they have potential both to improve and to disrupt patient care. To successfully implement technologies in the ICU, clinicians' perspectives are crucial. Understanding clinicians' perspectives can help limit the disruptive effects of new technologies, so clinicians can focus their time and attention on providing care to patients.Practice ImplicationsAs technology and data continue to play an increasingly important role in ICU care, everyone involved in the design, development, approval, implementation, and use of technology should work together to apply a sociotechnical systems approach to reduce possible negative effects on clinical care for critically ill patients.
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关键词
Critical care,qualitative,sociotechnical systems,technology implementation
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