Publications

@article{catchpole_rethinking_2025,

title = {Rethinking Anesthesia Medication “Errors”: The OR-SMART Patient Safety Learning Laboratory},

author = {Ken R. Catchpole and David M. Neyens and James H. Abernathy and Joshua Biro},

url = {https://journals.lww.com/10.1097/PTS.0000000000001384},

doi = {10.1097/PTS.0000000000001384},

issn = {1549-8417, 1549-8425},

year  = {2025},

date = {2025-07-01},

urldate = {2025-07-25},

journal = {Journal of Patient Safety},

abstract = {Purpose: 

 We combine the results of multiple studies to describe a systems engineering approach to a well-recognized patient safety problem. The goal of the Operating Room Systems-based Medication Administration error Reduction Team (OR-SMART) patient safety learning laboratory was to study the anesthesia medication work system to identify the characteristics of technologies and interventions that might feasibly reduce anesthesia medication errors. 

 Scope: 

 The work was conducted at 2 large urban academic medical centers: Johns Hopkins (JHU) and the Medical University of South Carolina (MUSC). We sampled across many different types of anesthesia work, understanding the challenges of work-as-done, and applying systems safety principles and evaluation frameworks. 

 Methods: 

 This was a mixed-methods study. Sources of data varied, with formal and informal interviews, formal and informal observations, video-based observations, hospital and national databases, and information from local incidents. Clinically embedded human factors professionals at both hospital sites facilitated informal sources of data. We explored the variable definitions of error; individual and organizational variability in decision-making; how syringes are used, stored, and moved within an operating room (OR); and used the Systems Engineering Initiative for Patient Safety (SEIPS) framework to model medication processes. We were able to identify more than 100 possible interventions, and then prioritized a few for development and testing. 

 Results: 

 We identified medication icon labels, a syringe holder hub, and workspace design guidelines as interventions for evaluation. Significant benefits of medication label icons were found in simulation and were highly utilized in practice. The syringe hub demonstrated high acceptability at one site but substantially less at another. A virtual reality-based evaluation of the OR design found that situational awareness, visual monitoring, and available workspace were subjectively improved.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{koscelny_emergency_2025,

title = {Emergency department visits for children identified as at risk of mental and behavioral conditions in the United States: an analysis of the 2019 NHIS data},

author = {Samuel N. Koscelny and David M. Neyens and Ann Dietrich and Danielle Stewart and Veronica Parker and Anjali Joseph},

url = {https://doi.org/10.1186/s12913-025-12792-9},

doi = {10.1186/s12913-025-12792-9},

issn = {1472-6963},

year  = {2025},

date = {2025-05-01},

journal = {BMC Health Services Research},

volume = {25},

number = {1},

pages = {636},

abstract = {The prevalence of mental and behavioral health (MBH) conditions in children has been increasing in the past two decades. Emergency departments (EDs) are also experiencing a significant rise in MBH-related visits, leading to challenges in providing care. Gaining insight into the underlying characteristics of pediatric patients at higher risk of MBH conditions is crucial for understanding this population in the ED and addressing their complex care needs. This study aims to examine the characteristics of children reported to be at risk and not at risk of MBH conditions to identify the population characteristics associated with ED visits. The objective was to analyze data from the 2019 National Health Interview Survey (NHIS) to evaluate the odds of ED visits among children and to identify patterns among those at higher risk of MBH conditions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{haughey_identifying_2025,

title = {Identifying Strategies for Home Management of Ostomy Care: Content Analysis of YouTube},

author = {Marketa Haughey and David M Neyens and Casey S Hopkins and Christofer Gonzaga and Melinda Harman},

url = {http://www.ncbi.nlm.nih.gov/pubmed/40053741},

doi = {10.2196/66634},

issn = {2292-9495},

year  = {2025},

date = {2025-03-01},

journal = {JMIR Hum Factors},

volume = {12},

pages = {e66634},

abstract = {Background: The social media platform YouTube is a recognized educational resource for health information, but few studies have explored its value for conveying the lived experience of individuals managing chronic health conditions and end users' interactions with medical device technology. Our study explores self-care strategies and end user needs of people living with a stoma because patient education and engagement in ostomy self-care are essential for avoiding ostomy-related complications. Ostomy surgery creates a stoma (an opening) in the abdomen to alter the route of excreta from digestive and urinary organs into a detachable external pouching system. After hospital discharge, people who have undergone ostomies perform critical self-care tasks including frequent ostomy appliance changes and stomal and peristomal skin maintenance. Objective: The purpose of this study was to systematically assess YouTube videos narrated by people who have undergone ostomies about their ostomy self-care in home (nonhospital) settings with a focus on identifying end user needs and different strategies used by people who have undergone ostomies during critical self-care tasks. Methods: Using predefined search terms and clear inclusion and exclusion criteria, we identified YouTube videos depicting narrators who have undergone ostomies and their ostomy self-care in home settings. Using a consensus coding approach among 3 independent reviewers, all videos were analyzed to collect metadata, data of narrators who have undergone ostomies, and specific content data. Results: There were 65 user-generated YouTube videos that met the inclusion and exclusion criteria. These videos were posted by 28 unique content creators representing a broad range of ages who used a variety of supplies. The common challenges discussed were peristomal skin complications, inadequate appliance adhesion and subsequent leakage, and supplies-related challenges. Narrators who have undergone ostomies discussed various expert tricks and tips to successfully combat these challenges. Conclusions: This study used a novel approach to gain insights about end user interactions with medical devices while performing ostomy self-care, which are difficult to gain using traditional behavioral techniques. The analysis revealed that people who have undergone ostomies are willing to share their personal experience with ostomy self-care on the web and that these videos are viewed by the public. User-generated videos demonstrated a variety of supplies used, end user needs, and different strategies for performing ostomy self-care. Future research should examine how these findings connect to YouTube ostomy self-care content generated by health care professionals and organizations and to guidelines for ostomy self-care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{info:doi/10.2196/58362,

title = {Examining Individuals' Use of the Internet for Health Care Activities Over Time: Results from the US National Health Interview Survey},

author = {Zachary Junkins and Nusrath Zahan and David Neyens},

url = {https://doi.org/10.2196/58362},

doi = {10.2196/58362},

issn = {2292-9495},

year  = {2025},

date = {2025-02-26},

journal = {JMIR Hum Factors},

volume = {12},

pages = {e58362},

abstract = {Background: Telehealth is an increasingly important component of health care services. Telehealth services may present an opportunity to increase the equity, accessibility, and effectiveness of health care. As such, it is critical that telehealth design focuses on reducing the barriers to access and usability that may impair some telehealth users. Objective: Our goal was to identify different demographic characteristics, behaviors, or opinions that may predict groups who are likely to face a barrier to using telehealth services. Methods: We used data from the National Health Interview Survey and multiple logit regression models focused on different aspects of telehealth to examine three different avenues of telehealth service: looking up health information using the internet, scheduling an appointment using the internet, and communicating with a care provider through email using the internet in order to consider the ways in which different telehealth services may face different barriers. Results: Our results suggest that middle-aged (36-55 years old) and older adult (56-85 years old) respondents were significantly less likely to look up health information using the internet or schedule an appointment using the internet versus younger individuals (18-35 years old). Specifically, our analysis found that middle-aged adults were found to have a higher odds ratio than older adults (0.83 vs 0.65) for looking up health information using the internet. We also found that there were differences in age groups for using technology to perform health care–related tasks. In terms of searching for health information using the internet and scheduling appointments using the internet, we found differences between men and women, with women being significantly more likely than men to look up health information using the internet, schedule an appointment using the internet, and communicate with a care provider through email using the internet. Across all the investigated variables, we found that the rates of using the internet for looking up health information, scheduling an appointment, and communicating with a care provider over email increased substantially across the study period. The impact of costs was inconsistent across the different models in our analysis. We also found that there is a strong correlation between respondents' collaboration in their personal health and the likelihood that they would use telehealth services to meet these needs. Conclusions: This analysis provides an exploratory look at the data to highlight barriers that may impact a user's ability to access telehealth services in the context of other potential predictor variables to account for the real-world variability that these may present. Future work should examine the complex relationships of those variables and understand how these interactions are correlated with the respondents' use of telehealth.},

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pubstate = {published},

tppubtype = {article}

}

@article{Conner29042025,

title = {Engineering Identity of Non-Traditional Students in an Undergraduate Transfer Program},

author = {Shannon Conner and Tyler Harvey and D. Matthew Boyer and Mary E. Kurz and David Neyens},

url = {https://doi.org/10.1080/07377363.2025.2468403},

doi = {10.1080/07377363.2025.2468403},

year  = {2025},

date = {2025-01-01},

journal = {The Journal of Continuing Higher Education},

volume = {0},

number = {0},

pages = {1–15},

publisher = {Routledge},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{doi:10.1177/19375867251317231,

title = {Proposing Design Evaluation Metrics for Anesthesia Providers’ Workspace in Ambulatory Surgical Settings},

author = {Devi Abhishek Soman and Mina Shokrollahi Ardekani and Anjali Joseph and David Neyens and Sahar Mihandoust and David Allison and Ken Catchpole and James H. AbernathyIII},

url = {https://doi.org/10.1177/19375867251317231},

doi = {10.1177/19375867251317231},

year  = {2025},

date = {2025-01-01},

journal = {HERD: Health Environments Research & Design Journal},

volume = {18},

number = {2},

pages = {115-138},

abstract = {Objective: This paper describes the development and utilization of two design evaluation metrics aimed to measure design performance for improving circulation and workflow, situational awareness, and visibility for medication-related activities for anesthesia providers’ within their workspace in operating rooms. Background: Proactive performance evaluation of the design of critical areas such as operating rooms can help improve the safety of patients and staff workflows. This paper builds on previous work on task-switching behaviors in anesthesia workspaces to develop performance-based design evaluation metrics for anesthesia providers’ workspaces based on their tasks performed during the patient preparation, intra-operative, and post-operative phases of the surgery, considering the presence of multiple anesthesia providers. Methods: Pre-coded observational data for five ear, nose, and throat surgeries was analyzed to determine the task-location and task-durations for anesthesia providers while performing various medication-related tasks. The distance between task-locations and the frequency of anesthesia providers’ movement between these locations informed the proximity metric, whereas the anesthesia providers’ visibility of the patient and the vitals screen from these locations informed the visibility metric. These metrics were used to compare four anesthesia providers’ workspace layouts: observed operating room, prototype operating room, and two newly developed design configurations A1 and A2. Results: The proximity metric suggests that layout A2 supported better circulation and workflow for anesthesia providers, whereas the visibility metric indicated that they had improved situational awareness in both A1 and A2. Conclusions: Both metrics can be used to proactively evaluate anesthesia providers’ workspaces early in the design process, to improve patient care in future operating rooms.},

note = {PMID: 40007110},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{SOMAN2025104512,

title = {Using patient journey mapping and provider workflows to understand process barriers to pediatric mental and behavioral health care in emergency departments},

author = {Devi Abhishek Soman and Samuel Nelson Koscelny and David Neyens and Ann Dietrich and Meera Narasimhan and Kevin Taaffe and David Allison and Anjali Joseph},

url = {https://www.sciencedirect.com/science/article/pii/S0003687025000481},

doi = {https://doi.org/10.1016/j.apergo.2025.104512},

issn = {0003-6870},

year  = {2025},

date = {2025-01-01},

journal = {Applied Ergonomics},

volume = {126},

pages = {104512},

abstract = {With the rise in mental and behavioral health (MBH) conditions among school-age children in the United States (US), the number of Emergency Department (ED) visits have also increased. However, ED settings struggle to meet the needs of children with MBH conditions safely and efficiently. This study integrated SEIPS (Systems Engineering Initiative for Patient Safety) 3.0 and 2.0 frameworks to explore the temporal and non-linear aspects of pediatric MBH patients’ journey and work processes (professional, patient, and collaborative work) to identify process barriers to pediatric MBH care in the ED. This mixed-method, multiple case study used observations, staff interviews, and time stamps of patient visits from electronic medical records at four EDs in the south-eastern US to inform the integrated patient journey and staff workflow process maps. Most barriers identified related to “medical and psychiatric evaluations” and “disposition and treatment plan” segments of the patient journey, suggesting potential points for interventions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{KOSCELNY2025104515,

title = {Generative AI responses are a dime a dozen; Making them count is the challenge – Evaluating information presentation styles in healthcare chatbots using hierarchical Bayesian regression models},

author = {Samuel N. Koscelny and Sara Sadralashrafi and David M. Neyens},

url = {https://www.sciencedirect.com/science/article/pii/S0003687025000511},

doi = {https://doi.org/10.1016/j.apergo.2025.104515},

issn = {0003-6870},

year  = {2025},

date = {2025-01-01},

journal = {Applied Ergonomics},

volume = {128},

pages = {104515},

abstract = {The emergence of large language models offers new opportunities to deliver effective healthcare information through web-based healthcare chatbots. Health information is often complex and technical, making it crucial to design human-AI interactions that effectively meet user needs. Employing a 2x2 between subjects design, we controlled for two independent variables: communication style (conversational vs. informative) and language style (technical vs. non-technical). We used hierarchical Bayesian regression models to assess the impact varying information presentation styles on effectiveness, trustworthiness, and usability. The findings revealed perceptions of low usability significantly decreased the effectiveness of the healthcare chatbot. Additionally, participants exposed to the conversational style of the chatbot had significantly increased likelihoods to perceive it with higher usability but were also more likely to be less trusting of the chatbot. These results indicate varying information presentation styles can impact user experience and offers insights for future research with healthcare chatbots and other AI systems.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{DEFOREST2025104555,

title = {Modeling anesthesia medication delivery using the SEIPS 101 tools},

author = {Elise DeForest and Ken Catchpole and Connor Lusk and James H. Abernathy and David M. Neyens},

url = {https://www.sciencedirect.com/science/article/pii/S0003687025000912},

doi = {https://doi.org/10.1016/j.apergo.2025.104555},

issn = {0003-6870},

year  = {2025},

date = {2025-01-01},

journal = {Applied Ergonomics},

volume = {128},

pages = {104555},

abstract = {Background 

Reducing the risk of patient harm during anesthesia medication administration in perioperative settings has been a long-term goal in patient safety. SEIPS 101 tools, provide a series of practice-orientated techniques to apply systems model in real clinical practice, potentially offering a straightforward approach to mapping perioperative medication delivery systems. Data was collected during direct observations of thirty-eight anesthetics, totaling over 100 h on anesthesia providers’ common tasks and interactions with people, environments, tools, and technologies. Observation data, notes, interviews, and literature were organized to create six SEIPS 101 tools demonstrating the complexity of anesthesia medication delivery. The Anesthesia PETT Scan represents the facilitators and barriers associated with differences in individual expertise, preferences, and potential conflict between providers. The People Map demonstrates the wide range of relevant individuals in medication delivery. The Task x Tools Matrix depicts the broad range of interconnected processes to provide anesthesia. The Journey Map describes the path used to deliver a medication. The Anesthesia Work System Interactions Map identifies necessary interactions that providers have with tools, tasks, people, and environment for successful anesthetics. The Outcome Matrix describes various stakeholder experiences and outcomes that contribute to overall system complexity. Identifying and describing the complexity in the anesthesia care delivery system is critical for effective and efficient process-centric interventions. This systems analysis may increase awareness to the limitations of current approaches and improve upon methods and interventions for understanding errors, safety, and the nature of clinical expertise and decision making.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yin2024,

title = {Examining how information presentation methods and a chatbot impact the use and effectiveness of electronic health record patient portals: An exploratory study},

author = {Rong Yin and David M. Neyens},

doi = {10.1016/j.pec.2023.108055},

issn = {0738-3991},

year  = {2024},

date = {2024-02-00},

journal = {Patient Education and Counseling},

volume = {119},

publisher = {Elsevier BV},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{YIN2024108055,

title = {Examining how information presentation methods and a chatbot impact the use and effectiveness of electronic health record patient portals: An exploratory study},

author = {Rong Yin and David M. Neyens},

url = {https://www.sciencedirect.com/science/article/pii/S0738399123004366},

doi = {https://doi.org/10.1016/j.pec.2023.108055},

issn = {0738-3991},

year  = {2024},

date = {2024-01-01},

journal = {Patient Education and Counseling},

volume = {119},

pages = {108055},

abstract = {Objectives 

Examining information presentation strategies that may facilitate patient education through patient portals is important for effective health education. 

Methods 

A randomized exploratory study evaluated information presentation (text or videos) and a chatbot in patient education and examined several performance and outcome variables (e.g., search duration, Decisional Conflict Scale, and eye-tracking measures), along with a simple descriptive qualitative content analysis of the transcript of chatbot. 

Results Of the 92 participants, those within the text conditions (n = 46, p < 0.001), had chatbot experiences (B =−74.85},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{NEYENS2024104263,

title = {The movement of syringes and medication during anesthesiology delivery: An observational study in laparoscopic surgeries},

author = {David M. Neyens and Rong Yin and James H. Abernathy and Catherine Tobin and Candace Jaruzel and Ken Catchpole},

url = {https://www.sciencedirect.com/science/article/pii/S0003687024000401},

doi = {https://doi.org/10.1016/j.apergo.2024.104263},

issn = {0003-6870},

year  = {2024},

date = {2024-01-01},

journal = {Applied Ergonomics},

volume = {118},

pages = {104263},

abstract = {The movements of syringes and medications during an anesthetic case have yet to be systematically documented. We examine how syringes and medication move through the anesthesia work area during a case. We conducted a video-based observational study of 14 laparoscopic surgeries. We defined 'syringe events' as when syringe was picked up and moved. Medications were administered to the patient in only 48 (23.6%) of the 203 medication or syringe events. On average, 14.5 syringe movements occurred in each case. We estimate approximately 4.2 syringe movements for each medication administration. When a medication was administered to the patient (either through the IV pump or the patient port), it was picked up from one of 8 locations in the work area. Our study suggests that the syringe storage locations vary and include irregular locations (e.g., patient bed or provider's pockets). Our study contributes to understanding the complexity in the anesthesia work practices.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{SIMS2024542,

title = {The Impact of a Novel Syringe Organizational Hub on Operating Room Workflow During a Surgical Case},

author = {Harrison Sims and David Neyens and Ken Catchpole and Joshua Biro and Connor Lusk and James Abernathy},

url = {https://www.sciencedirect.com/science/article/pii/S1553725024000680},

doi = {https://doi.org/10.1016/j.jcjq.2024.02.008},

issn = {1553-7250},

year  = {2024},

date = {2024-01-01},

journal = {The Joint Commission Journal on Quality and Patient Safety},

volume = {50},

number = {7},

pages = {542-544},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{HAUGHEY2024101579,

title = {Development and Evaluation of a Metric-based Clinical Simulation Procedure for Assessing Ostomy Care in Nursing Practice},

author = {Marketa Haughey and Melinda Harman and Casey Hopkins and Amanda Watson and Corbin Goodwin and Jenna Hines and Katelyn Sullivan and Chris Gonzaga and Abigail Washburn and David M. Neyens},

url = {https://www.sciencedirect.com/science/article/pii/S1876139924000719},

doi = {https://doi.org/10.1016/j.ecns.2024.101579},

issn = {1876-1399},

year  = {2024},

date = {2024-01-01},

journal = {Clinical Simulation in Nursing},

volume = {94},

pages = {101579},

abstract = {Background 

There is a need to understand the clinical decision-making and work practices within ostomy nursing care to support expanding nursing training. 

Objective 

To develop and evaluate a new metric-based simulation for assessing ostomy nursing care using a human factors approach. 

Sample 

This pilot study involved eleven stakeholders in the needs assessment, six nurse participants performing simulated ostomy care, and three independent observers assessing procedure reliability. 

Method 

We conducted a needs assessment of ostomy nursing care and training, developed an enhanced metric-based simulation for ostomy appliance change procedures, and statistically evaluated its reliability for measuring the simulated tasks. 

Results 

The enhanced metric-based simulation captured different tasks within four task categories: product selection; stoma and peristomal skin care; baseplate sizing and adhesion; and infection control strategies. The video review procedure was reliable for assessing continuous (average ICC≥0.96) and categorical (average κ>0.96) variables. 

Conclusion 

The new metric-based simulation was suitable for characterizing a broad range of clinical decision-making and work practices in ostomy nursing care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{doi:10.1177/10711813241263509,

title = {The Effect of Healthcare Chatbots’ Information Presentation Styles on User Acceptance in a Knowledge Seeking Task},

author = {Samuel N. Koscelny and David M. Neyens},

url = {https://doi.org/10.1177/10711813241263509},

doi = {10.1177/10711813241263509},

year  = {2024},

date = {2024-01-01},

journal = {Proceedings of the Human Factors and Ergonomics Society Annual Meeting},

volume = {68},

number = {1},

pages = {493-498},

abstract = {The rise of large language models offers new opportunities for disseminating more effective and equitable healthcare information. While past research has extensively investigated users’ perceptions of chatbots, few have examined the design strategies for chatbot information presentation. The objective of this research aims to explore how communication style (conversational or informative) and language style (technical or non-technical) affect user acceptance and ability performing a knowledge seeking task with a healthcare chatbot in a 2 × 2 between-subjects design. Following this, participants engaged in semi-structured interviews, where we analyzed participants’ experiences through inductive thematic analysis. Our findings indicate users generally found conversational chatbots to be more understandable with greater perceived interaction freedom than informative chatbots. These insights highlight the importance of aligning chatbot communication with users’ expectations. Future research should validate these findings with larger and more diverse populations, considering the impact of various chatbot interaction styles on user experience and long-term effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{doi:10.1177/10711813241263511,

title = {Promoting Eco-Friendly Behavior in University Activity-Based Workspaces Through Eco-Feedback},

author = {Sara Sadralashrafi and Mohammadhossein Nahavandian and David M Neyens and Bart Knijnenburg and Da Li},

url = {https://doi.org/10.1177/10711813241263511},

doi = {10.1177/10711813241263511},

year  = {2024},

date = {2024-01-01},

journal = {Proceedings of the Human Factors and Ergonomics Society Annual Meeting},

volume = {68},

number = {1},

pages = {1012-1018},

abstract = {Eco-feedback has been demonstrated as an effective strategy to promote energy-saving behavior among occupants in buildings by providing real-time or historical information on energy consumption and environmental impacts. However, the application of eco-feedback in academic buildings for space choices is limited. In this study, we explored the impact of providing eco-feedback on occupants’ space choices in university Activity-Based Workspaces (ABW), where individuals select their workspaces using an online booking system. We designed two user interfaces: one baseline interface with no eco-feedback, and also an intervention interface that included eco-feedback. A within-subject user interface evaluation study was conducted, and the results suggest that eco-feedback significantly motivates occupants to select highly eco-friendly spaces (p-value < .05). Consequently, providing eco-feedback in university ABW environments can encourage more eco-friendly and sustainable decision making and has the potential to reduce the contribution of buildings in energy-related carbon emissions.},

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pubstate = {published},

tppubtype = {article}

}

@article{doi:10.1177/19375867231190646,

title = {Anesthesia Workspaces for Safe Medication Practices: Design Guidelines},

author = {Soheyla MohammadiGorji and Anjali Joseph and Sahar Mihandoust and Seyedmohammad Ahmadshahi and David Allison and Ken Catchpole and David Neyens and James H. AbernathyIII},

url = {https://doi.org/10.1177/19375867231190646},

doi = {10.1177/19375867231190646},

year  = {2024},

date = {2024-01-01},

journal = {HERD: Health Environments Research & Design Journal},

volume = {17},

number = {1},

pages = {64-83},

abstract = {Background: Studies show that workspace for the anesthesia providers is prone to interruptions and distractions. Anesthesia providers experience difficulties while performing critical medication tasks such as medication preparation and administration due to poor ergonomics and configurations of workspace, equipment clutter, and limited space which ultimately may impact patient safety, length of surgery, and cost of care delivery. Therefore, improving design of anesthesia workspace for supporting safe and efficient medication practices is paramount.Objectives: The objective of this study was to develop a set of evidence-based design guidelines focusing on design of anesthesia workspace to support safer anesthesia medication tasks in operating rooms (ORs).Methods: Data collection was based on literature review, observation, and coding of more than 30 prerecorded videos of outpatient surgical procedures to identify challenges experienced by anesthesia providers while performing medication tasks. Guidelines were then reviewed and validated using short survey.Results: Findings are summarized into seven evidence-based design guidelines, including (1) locate critical tasks within a primary field of vision, (2) eliminate travel into and through the anesthesia zone (for other staff), (3) identify and demarcate a distinct anesthesia zone with adequate space for the anesthesia provider, (4) optimize the ability to reposition/reconfigure the anesthesia workspace, (5) minimize clutter from equipment, (6) provide adequate and appropriately positioned surfaces for medication preparation and administration, and (7) optimize task and surface lighting.Conclusion: This study finds many areas for improving design of ORs. Improvements of anesthesia work area will call for contribution and cooperation of entire surgical team.},

note = {PMID: 37553817},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Sims2023,

title = {The design and evaluation of a syringe hub for organizing syringes in anesthesia medication delivery},

author = {Harrison Sims and Joshua Biro and Connor Lusk and David M. Neyens and Ken Catchpole and Abdus Sabour Shaik and Stephanie Munie and James H. Abernathy},

doi = {10.1016/J.HFH.2023.100049},

issn = {2772-5014},

year  = {2023},

date = {2023-01-01},

journal = {Human Factors in Healthcare},

volume = {4},

pages = {100049},

publisher = {Elsevier},

abstract = {One of the most common errors in intraoperative medication delivery is the result of “syringe swap,” when syringes that have been mixed up lead to the incorrect administration of a drug. An improvement of syringe organization could reduce medication administration errors. Recently, there have been many efforts to improve medication organization; however, these interventions struggle to achieve widespread use, even though they typically report substantial improvements in error rates and medication awareness in home institutions. A syringe organization hub was developed based on observations, interviews, and past designs. In order to assess the perceived acceptance of the hub, we used the Technology Acceptance Model (TAM) to develop a survey that was distributed to anesthesia providers at two medical institutions in the United States: one in the Mid-Atlantic and one in the southeast. The results of the four different linear regression models revealed that participants at the southeastern institution had significantly lower usefulness ratings (p<0.001), attitude ratings (p<0.001), and behavioral intent ratings (p<0.05) than participants at the Mid-Atlantic institution. The participants at the southeastern institution also reported more concerns about the implementation of the device, specifically regarding workflow deviation and cleanliness. The hub design was heavily influenced by the workflows and work practices of the Mid-Atlantic institution, and survey results found that this may have created barriers for acceptance at the southeastern institution. We found that, as barriers continue to go unaddressed at a given institution, even the simplest device can become disruptive to workflow, and there can be a struggle with integration. When interventions are developed, they are typically designed to address the barriers at the native institution. However, when seeking widespread adoption, small barriers to acceptance at non-native institutions can prevent adoption of interventions as they are not inherently factored into the design. Therefore, widespread adoption can only be accomplished by expanding the number of institutions in the design process, thereby accounting for the barriers to adoption and acceptance.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Biro2023,

title = {The Effects of a Health Care Chatbot's Complexity and Persona on User Trust, Perceived Usability, and Effectiveness: Mixed Methods Study.},

author = {Joshua Biro and Courtney Linder and David Neyens},

url = {http://www.ncbi.nlm.nih.gov/pubmed/36724004 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC9932873},

doi = {10.2196/41017},

issn = {2292-9495},

year  = {2023},

date = {2023-01-01},

journal = {JMIR human factors},

volume = {10},

issue = {1},

pages = {e41017},

publisher = {JMIR Human Factors},

abstract = {BACKGROUND The rising adoption of telehealth provides new opportunities for more effective and equitable health care information mediums. The ability of chatbots to provide a conversational, personal, and comprehendible avenue for learning about health care information make them a promising tool for addressing health care inequity as health care trends continue toward web-based and remote processes. Although chatbots have been studied in the health care domain for their efficacy for smoking cessation, diet recommendation, and other assistive applications, few studies have examined how specific design characteristics influence the effectiveness of chatbots in providing health information. OBJECTIVE Our objective was to investigate the influence of different design considerations on the effectiveness of an educational health care chatbot. METHODS A 2×3 between-subjects study was performed with 2 independent variables: a chatbot's complexity of responses (eg, technical or nontechnical language) and the presented qualifications of the chatbot's persona (eg, doctor, nurse, or nursing student). Regression models were used to evaluate the impact of these variables on 3 outcome measures: effectiveness, usability, and trust. A qualitative transcript review was also done to review how participants engaged with the chatbot. RESULTS Analysis of 71 participants found that participants who received technical language responses were significantly more likely to be in the high effectiveness group, which had higher improvements in test scores (odds ratio [OR] 2.73, 95% CI 1.05-7.41; P=.04). Participants with higher health literacy (OR 2.04, 95% CI 1.11-4.00},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{BIRO2022,

title = {Medication errors, critical incidents, adverse drug events, and more: examining patient safety-related terminology in anaesthesia},

author = {Joshua Biro and Maya Rucks and David M. Neyens and Sarah Coppola and James H. Abernathy and Ken R. Catchpole},

url = {https://www.sciencedirect.com/science/article/pii/S0007091221008515},

doi = {https://doi.org/10.1016/j.bja.2021.11.038},

issn = {0007-0912},

year  = {2022},

date = {2022-01-01},

journal = {British Journal of Anaesthesia},

abstract = {Summary 

Literature focused on quantifying or reducing patient harm in anaesthesia uses a variety of labels and definitions to represent patient safety-related events, such as ‘medication errors', ‘adverse events', and ‘critical incidents'. This review extracts and compares definitions of patient safety-related terminology in anaesthesia to examine the scope of this variability and inconsistencies. A structured review was performed in which 36 of the 769 articles reviewed met the inclusion criteria. Similar terms were grouped into six categories by similarities in keyword choice (Adverse Event, Critical Incident, Medication Error, Error, Near Miss, and Harm) and their definitions were broken down into three base components to allow for comparison. Our analysis found that the Medication Error category, which encompasses the greatest number of terms, had widely variant definitions which represent fundamentally different concepts. Definitions of terms within the other categories consistently represented relatively similar concepts, though key variations in wording remain. This inconsistency in terminology can lead to problems with synthesising, interpreting, and overall sensemaking in relation to anaesthesia medication safety. Guidance towards how ‘medication errors’ should be defined is provided, yet a definition will have little impact on the future of patient safety without organisations and journals taking the lead to promote, publish, and standardise definitions.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{ALFRED2022,

title = {Anaesthesia providers' perceptions of system safety and critical incidents in non-operating theatre anaesthesia},

author = {Myrtede C. Alfred and Abigail D. Herman and Dulaney Wilson and David M. Neyens and Candace B. Jaruzel and Catherine D. Tobin and Joseph G. Reves and Ken R. Catchpole},

url = {https://www.sciencedirect.com/science/article/pii/S0007091221008722},

doi = {https://doi.org/10.1016/j.bja.2021.12.041},

issn = {0007-0912},

year  = {2022},

date = {2022-01-01},

journal = {British Journal of Anaesthesia},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Goel2022,

title = {A User-Centered Approach to Designing Secondary Anesthesia Medication Labels},

author = {Swati Goel and Anjali Joseph and David M. Neyens and Kenneth Catchpole and Myrtede Alfred and Candace Jaruzel and Catherine Tobin and III James H Aberathy and Timothy Heinke and Jason Haney},

url = {https://journals.sagepub.com/doi/abs/10.1177/1071181322661100},

doi = {10.1177/1071181322661100},

issn = {2169-5067},

year  = {2022},

date = {2022-01-01},

journal = {https://doi.org/10.1177/1071181322661100},

volume = {66},

issue = {1},

pages = {2127-2131},

publisher = {SAGE PublicationsSage CA: Los Angeles, CA},

abstract = {Poorly designed and implemented medication labels have been identified as a source of medication errors within anesthesia delivery. Previous studies noted that simplified text and icons are useful ...},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yin2022,

title = {Who is using a mobile app and who is using a computer to access their patient portals?},

author = {Rong Yin and David M. Neyens},

url = {https://journals.sagepub.com/doi/abs/10.1177/1071181322661316},

doi = {10.1177/1071181322661316},

issn = {2169-5067},

year  = {2022},

date = {2022-01-01},

journal = {https://doi.org/10.1177/1071181322661316},

volume = {66},

issue = {1},

pages = {1569-1573},

publisher = {SAGE PublicationsSage CA: Los Angeles, CA},

abstract = {The use of patient portals to access online medical records provides patients with multiple benefits like improving patient-provider communication, access to information, and improvements in self-m...},

keywords = {},

pubstate = {published},

tppubtype = {article}

}