Austin Mount-Campbell, PhD, MS

Lead Research Investigator

Publications

Uncovering the Value of a Historical Paper-Based Collaborative Artifact: The Nursing Unit's Kardex System
Uncovering the Value of a Historical Paper-Based Collaborative Artifact: The Nursing Unit's Kardex System
Mount-Campbell AF, Evans KD, Woods DD, Chipps E, Moffatt-Bruce SD, Patel K, Patterson ES

Front Digit Health 2020 ;2():12

PMID: 34713025

Abstract

We identify useful functions and usability characteristics of a historical cognitive artifact used by nurses working in a hospital unit, the Kardex. By identifying aspects of a widely used artifact, we uncover opportunities to improve the usefulness of current systems for hospital nurses. We conducted semi-structured interviews with registered nurses about their prior experience with the Kardex. Questions included what elements of the Kardex are missing from their current electronic support. Memos were generated iteratively from interview transcript data and grouped into themes. Eighteen nurses from multiple clinical areas participated and had a median of 25-29 years of nursing experience. The themes were: (1) a status at a glance summary for each patient, (2) a prospective memory aid, (3) efficiency and ease of use, (4) updating information required to maintain value, (5) activity management, (6) verbal handover during shift-to-shift report, (7) narrative charting and personalized care, and (8) non-clinical care communication. Implications for digital support are to provide immediate, portable access to a standardized patient summary, support for nurses to manage their planned activities during a series of shifts, provide unstructured text fields for narrative charting, and to support adding informal notes for personalized care.
See more publications from Christiana Care experts
Patient-Centered Handovers: Ethnographic Observations of Attending and Resident Physicians: Ethnographic Observations of Attending and Resident Physicians
Patient-Centered Handovers: Ethnographic Observations of Attending and Resident Physicians: Ethnographic Observations of Attending and Resident Physicians
Mount-Campbell AF, Rayo MF, OʼBrien JJ, Allen TT, Patterson ES

Qual Manag Health Care 2016 Oct/Dec;25(4):225-230

PMID: 27749720

Abstract

Handover communication improvement initiatives typically employ a "one size fits all" approach. A human factors perspective has the potential to guide how to tailor interventions to roles, levels of experience, settings, and types of patients. We conducted ethnographic observations of sign-outs by attending and resident physicians in 2 medical intensive care units at one institution. Digitally audiotaped data were manually analyzed for content using codes and time spent using box plots for emergent categories. A total of 34 attending and 58 resident physician handovers were observed. Resident physicians spent more time for "soon to be discharged" and "higher concern" patients than attending physicians. Resident physicians spent less time discussing patients which they had provided care for within the last 3 days ("handbacks"). The study suggested differences for how handovers were conducted for attending and resident physicians for 3 categories of patients; handovers differ on the basis of role or level of expertise, patient type, and amount of prior knowledge of the patient. The findings have implications for new directions for subsequent research and for how to tailor quality improvement interventions based upon the role, level of experience, level of prior knowledge, and patient categories.
See more publications from Christiana Care experts
HOW NURSES IDENTIFY HOSPITALIZED PATIENTS ON THEIR PERSONAL NOTES: FINDINGS FROM ANALYZING 'BRAINS' HEADERS WITH MULTIPLE RATERS
HOW NURSES IDENTIFY HOSPITALIZED PATIENTS ON THEIR PERSONAL NOTES: FINDINGS FROM ANALYZING 'BRAINS' HEADERS WITH MULTIPLE RATERS
Sarkhel R, Socha JJ, Mount-Campbell A, Moffatt-Bruce S, Fernandez S, Patel K, Nandi A, Patterson ES

Proc Int Symp Hum Factors Ergon Healthc 2018 Jun;7(1):205-209

PMID: 30069493

Abstract

The overarching objective of this research is to reduce the burden of documentation in electronic health records by registered nurses in hospitals. Registered nurses have consistently reported that e-documentation is a concern with the introduction of electronic health records. As a result, many nurses use handwritten notes in order to avoid using electronic health records to access information about patients. At the top of these notes are patient identifiers. By identifying aspects of good and suboptimal headers, we can begin to form a model of how to effectively support identifying patients during assessments and care activities. The primary finding is that nurses use room number as the primary patient identifier in the hospital setting, not the patient's last name. In addition, the last name, gender, and age are sufficiently important identifiers that they are frequently recorded at the top of handwritten notes. Clearly distinguishable field labels and values are helpful in quickly scanning the identifier for identifying information. A web based annotator was designed as a first step towards machine learning approaches to recognize handwritten or printed data on paper sheets in future research.
See more publications from Christiana Care experts
APPLYING HUMAN FACTORS ENGINEERING TO IMPROVE USABILITY AND WORKFLOW IN PATHOLOGY INFORMATICS
APPLYING HUMAN FACTORS ENGINEERING TO IMPROVE USABILITY AND WORKFLOW IN PATHOLOGY INFORMATICS
Mount-Campbell AF, Hosseinzadeh D, Gurcan M, Patterson ES

Proc Int Symp Hum Factors Ergon Healthc 2017 Jun;6(1):23-27

PMID: 30073176

Abstract

Human factors engineering is an underutilized approach in the design, evaluation, and implementation of health information technology. Heuristic evaluation of the usability of an interface is a 'low-hanging fruit' for identifying a set of relatively simple modifications to a software program that can make software easier to use. In this paper, we describe recommendations to improve the usability of a software package used to view digitized images of tissues by pathologists. Several recommendations were immediately implemented, and others are planned for future releases. The changes are anticipated to be more compatible with user expectations from interacting with similar elements in other packages, and thus easier to learn and use.
See more publications from Christiana Care experts
Interactive questioning in critical care during handovers: a transcript analysis of communication behaviours by physicians, nurses and nurse practitioners
Interactive questioning in critical care during handovers: a transcript analysis of communication behaviours by physicians, nurses and nurse practitioners
Rayo MF, Mount-Campbell AF, O'Brien JM, White SE, Butz A, Evans K, Patterson ES

BMJ Qual Saf 2014 Jun;23(6):483-9

PMID: 24336577

Abstract

OBJECTIVE: Although there is a growing recognition of the importance of active communication behaviours from the incoming clinician receiving a patient handover, there are currently no agreed-upon measures to objectively describe those behaviours. This study sought to identify differences in incoming clinician communication behaviours across levels of clinical training for physicians and nurses.
METHODS: Handover observations were conducted during shift changes for attending physicians, resident physicians, registered nurses and nurse practitioners in three medical intensive care units from July 2011 to August 2012. Measures were the number of interjections from the incoming clinician and the communication mode of those interjections. Each collaborative cross-check, a specific type of interactive question, was subsequently classified by level of assertiveness.
RESULTS: 133 patient handovers were analysed. Statistical differences were found in both measures. Higher levels of training were associated with fewer interjections, and a higher proportion of interactive questioning to detect erroneous assessments and actions by the incoming provider. All groups were observed to use the least assertive level of a collaborative cross-check, which contributed to misunderstandings. Nurses used less assertive collaborative cross-checks than physicians.
CONCLUSIONS: Differences across clinician type and levels of clinical training were found in both measures during patient handovers. The findings suggest that training could enable physicians and nurses to learn communication competencies during patient handovers which were used more frequently by more experienced practitioners, including interjecting less frequently and using interactive questioning strategies to clarify understanding, and assertively question the appropriateness of diagnoses, treatment plans and prognoses. Accompanying cultural change initiatives might be required to routinely employ these strategies in the clinical setting, particularly for nursing personnel.
See more publications from Christiana Care experts