Shared sensemaking and clinical decision-making in critical care from a SA-oriented dashboard

At the start of the COVID-19 pandemic, Intensive Care Units (ICUs) admitted an unusually high number of patients suffering from the most severe respiratory effect of the disease. The clinicians worked in teams in a context where resources were limited, and efficient resourcemanagement was key to ensure on-time healthcare delivery. Our team of researchers adopted the situation awareness (SA) model to design a SA-oriented dashboard. The main research objective was to improve clinicians’ situation awareness, through the visualization of resource management key indicators to perceive on what is going on, comprehend its meaning and project future actions. A total of 17 clinicians participated to the dashboard design. We used the conceptual framework of the staff-stuff-space-system-of-care (4S) factors to resource management in critical care. A user-centred design method allowed to define the dashboard key indicators from the clinicians’ situation awareness goals (perceive, comprehend, project) and 4S information requirements. However, the outcomes revealed that little was known on how the 4S factors to the clinician situation awareness contributed to a shared sensemaking and to clinical decision-making among the team members. We found a core factor to a shared sensemaking identified as "health Status at bedside". This 5th "S" factor informs the clinician team on both the 4S (staff-stuff-space-system regulation) resources in used and the clinical condition at bedside. From then, we identified the 5S factors as the drivers of the clinicians’ cognitive processes in critical care. We synthesized the research outcomes in the Situation Awareness and Shared Sensemaking Decision Model (SASS). We conclude by suggesting that much can be gained from the evaluation of the SASS model in critical care.

Uncontrolled Keywords

Clinical Decision-making; Critical Care; Dashboard; Intensive Care Unit; Shared Sensemaking; Situation Awareness