A 1999 Institute of Medicine report suggested that between 44.000 and 98.000 people die from medical errors each year in the United States. That is more deaths annually than those attributed to breast cancer, human immunodeficiency virus (HIV) or motor vehicle accidents.
Previous research confirms that the complexity of health care delivery systems often are the primary barrier to implementing more effective measures to ensure patient safety, especially in intensive care units and surgery departments, according to Vimla L. Patel.
Studies show the root of the problem is generally not inadequate performance by individual health care professionals, Professor Patel stated. It more often is factors inherent in the traditional medical culture: the conventional health care management and decision-making processes in complex health care systems.
"The project addresses how humans think and solve problems in a medical context", stated John Bruer, the McDonnell Foundation's president. Medical error "is a very significant social problem that requires more basic cognitive science research if we are going to solve it", John Bruer continued.
The foundation, founded in 1950 by McDonnell, an aerospace pioneer, was established to "improve the quality of life". It contributes to the quest for new knowledge through funding for research and scholarship programmes. It gives about $25 million each year to support neuroscience, psychology and complex systems research, according to John Bruer.
The ASU project it is supporting will bring together experts in the sciences of cognition and complex systems, biomedical informaticians, simulation experts and critical-care clinicians. Their goal is to produce model systems for improving error detection and correction in emergency medicine and intensive-care environments.
"The behaviour of the system as a whole is considerably more complex than that of any of its parts", Professor Patel stated. "Thought processes underlying critical care are distributed across the minds of many types of clinicians and health care providers, as well as physical objects such as notes and computer equipment. The notion of distributed cognition shifts the focus of cognitive science from the study of individuals in controlled settings to the study of groups of individuals in their real-world context."
Over the course of the project, the research partners will hold a conference annually to explore applications of their work with other science and health care groups. Those are to include the Northwestern Institute on Complex Systems at Northwestern University, the Complexity in Social Science project based in France, and the Toronto-based Cochran Foundation.
Private-sector companies who will collaborate with the project include Immersion Inc., an expert in medical and surgical simulation; Visicu Inc., a health care solutions company; and Intermec Inc., specialized in medical information systems and technologies.
Professor Patel, who came to ASU earlier this year from Columbia University in New York, explained that she has been thinking about the ideas behind the project for the past several years. "But after coming to Arizona, I made it my priority to develop the ideas further and assemble a collaborative team of researchers", she stated. "So I am thrilled that the James S. McDonnell Foundation and its board of directors are as excited about this as I am."
The principal members of Professor Patel's team are:
- Trevor Cohen and Kanav Kahol, assistant professors of biomedical informatics at ASU.
- Jiajie Zhang, a professor at the School of Health Information Sciences at the University of Texas-Houston.
- Timothy G. Buchman, Edison Professor of Surgery and a professor of anaesthesiology and medicine at the University of Washington in St. Louis.
- From Banner Health System: John J. Ferrara, programme director for the Phoenix Integrated Surgical Residency and director of the Level I Trauma Center for Banner Good Samaritan Medical Center; Marshall Smith, clinical director of the Banner Simulation Education and Training Center, and counsel for the Banner Health System for simulation and telemedicine; and Robert H. Groves, medical director for Critical Care-Banner Health and medical director of Intensive Care, e-ICU.