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Presentation

Redesigning Communication and Care for Children with Type 1 Diabetes or Autism Spectrum Disorder, and their Families
Event Type
Oral Presentations
TimeThursday, April 1511:00am - 11:20am EDT
LocationHospital Environments
DescriptionChildren are especially vulnerable to preventable harm caused by healthcare for many reasons, including weight-based medication dosing, handoffs between caregivers, and their limited ability to communicate evolving symptoms. At home, two in five children with chronic disease suffer a medication error. Of these, 3.6% are injured due to these errors—the same rate as all hospitalized children. Among the 165,000 children with type 1 diabetes (T1D) nationally, 20% have poor glycemic control. The leading cause of death before age 30 among individuals with T1D is acute complications (e.g., severe hypoglycemia, diabetic ketoacidosis).

The Pediatric Patient Safety Learning Lab aims to improve care of children with T1D by, (1) Redesigning processes for medication dosing adjustment based on real-time clinical information gathered by patient/family/caregivers to prevent medication errors, (2) Creating processes for patient/family medication monitoring and communication with hospital-based clinic teams to prevent adverse drug events, and (3) Designing a workflow to plan for, detect, and prompt management of potential serious symptoms or illness among children with T1D at home. This learning lab integrates design and systems engineering—in collaboration with the design firm Mad*Pow and University of Wisconsin Systems Engineering Initiative for Patient Safety—with Cincinnati Children’s expertise in patient-centered research and implementation. The overarching goal is to redesign systems of care and coordination between the hospital-based clinic and home to eliminate harm due to healthcare in these settings.

To date, we have performed mixed methods research of hospital-based clinicians, children, and families through: 1) an in-depth problem analysis employing in-home and clinic observations and interviews of families of patients with T1D and clinic staff, 2) a series of failure modes and effects analyses, and 3) deploying parent digital diaries. These data were synthesized and used to inform a series of design sessions, where families and clinicians produced target ideal behaviors and solution spaces. Several solutions spaces were selected, and interventions are now entering the user-centered design phase. We present our methodology and overview of the findings during the problem analysis phase, as well as share our evolving solutions and design prototypes.