Acute Care Learning Laboratory - Reducing Threats to Diagnostic Fidelity in Critical Illness

Project Summary/Abstract The COVID-19 pandemic presents unprecedented challenges for the US healthcare system. While critical care settings are most impacted by the pressures of caring for COVID-19 patients,entire care delivery systems must mobilize and reallocate resources. As part of our parent award, our acute care learning lab has focused on conceptualizing the healthcare system and describing the diverse sociotechnical factors that contribute to diagnostic error and delay. The work of preparing for and responding to COVID-19 amounts to the adaptation of very complex sociotechnical systems. How this work is best managed and the diverse factors that contributeto its success are poorly understood.The broad objective of this proposal is to leverage our learning lab expertise and connections to hospitals nationwide, to fill this important gap in our understanding. We will achieve this through systematically capturing and analyzing the experiences of front-line health careworkers, administrators and other stakeholders as their health systems adapt to the pandemic.Aim 1: Engage key stakeholders in qualitatively identifying sociotechnical factors impacting theability of hospitals and health systems to effectively care for critically ill patients during COVID-19 pandemic surge conditions. Aim 2: Develop and rapidly pre-test a questionnaire that will capture the prevalence andimportance of key sociotechnical factors identified by stakeholders in aim 1 as impacting their ability to effectively care for critically ill patients during COVID-19 pandemic surge conditions Aim 3: In a multicenter/multistate survey of stakeholders, establish the prevalence and importance of key sociotechnical factors that determine the ability of a diverse array of hospital settings to respond effectively to the needs of critically ill patients during COVID-19 pandemic conditions.