We describe an analysis of speech during time-critical, team-based medical work and its potential to indicate process delays. We analyzed speech intention and sentence types during 39 trauma resuscitations with delays in one of three major lifesaving interventions: intravenous/intraosseous (IV/IO) line insertion, cardiopulmonary and resuscitation (CPR), and intubation. We found a significant difference in patterns of speech during delays vs. speech during non-delayed work. The speech intention during CPR delays, however, differed from the other LSIs, suggesting that context of speech must be considered. These findings will inform the design of a clinical decision support system (CDSS) that will use multiple sensor modalities to alert medical teams to delays in real time. We conclude with design implications and challenges associated with speech-based activity recognition in complex medical processes.
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Characterizing Speech in Life Saving Interventions to Inform Computerized Clinical Decision Support for Complex Medical Teamwork
We describe an initial analysis of speech during team-based medical scenarios and its potential to indicate process delays in an emergency medical setting. We analyzed the speech of trauma resuscitation teams in cases with delayed intravenous/intraosseous (IV/IO) line placement, a significant contributor to delays during life-saving interventions. The insights gained from this analysis will inform the design of a clinical decision support system (CDSS) that will use multiple sensor modalities to alert medical teams to errors in real time. We contribute to the literature by determining how the intention of each speech line and the sentence can support real-time, automatic detection of delays during time-critical team activities.
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- Award ID(s):
- 1763509
- PAR ID:
- 10379020
- Date Published:
- Journal Name:
- Companion Publication of the 2021 Conference on Computer Supported Cooperative Work and Social Computing
- Page Range / eLocation ID:
- 199 to 202
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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We describe an analysis of speech during time-critical, team-based medical work and its potential to indicate process delays. We analyzed speech intention and sentence types during 39 trauma resuscitations with delays in one of three major lifesaving interventions: intravenous/intraosseous (IV/IO) line insertion, cardiopulmonary and resuscitation (CPR), and intubation. We found a significant difference in patterns of speech during delays vs. speech during non-delayed work. The speech intention during CPR delays, however, differed from the other LSIs, suggesting that context of speech must be considered. These findings will inform the design of a clinical decision support system (CDSS) that will use multiple sensor modalities to alert medical teams to delays in real time. We conclude with design implications and challenges associated with speech-based activity recognition in complex medical processes.more » « less
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We describe an experiment conducted with three domain experts to understand how well they can recognize types and performance stages of activities using speech data transcribed from verbal communications during dynamic medical teamwork. The insights gained from this experiment will inform the design of an automatic activity recognition system to alert medical teams to process deviations in real time. We contribute to the literature by (1) characterizing how domain experts perceive the dynamics of activity-related speech, and (2) identifying the challenges associated with system design for speech-based activity recognition in complex team-based work settings.more » « less
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Designing computerized approaches to support complex teamwork requires an understanding of how activity-related information is relayed among team members. In this paper, we focus on verbal communication and describe a speech-based model that we developed for tracking activity progression during time-critical teamwork. We situated our study in the emergency medical domain of trauma resuscitation and transcribed speech from 104 audio recordings of actual resuscitations. Using the transcripts, we first studied the nature of speech during 34 clinically relevant activities. From this analysis, we identified 11 communicative events across three different stages of activity performance-before, during, and after. For each activity, we created sequential ordering of the communicative events using the concept of narrative schemas. The final speech-based model emerged by extracting and aggregating generalized aspects of the 34 schemas. We evaluated the model performance by using 17 new transcripts and found that the model reliably recognized an activity stage in 98% of activity-related conversation instances. We conclude by discussing these results, their implications for designing computerized approaches that support complex teamwork, and their generalizability to other safety-critical domains.more » « less
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Almost half of the preventable deaths in emergency care can be associated with a medical delay. Understanding how clinicians experience delays can lead to improved alert designs to increase delay awareness and mitigation. In this paper, we present the findings from an iterative user-centered design process involving 48 clinicians to develop a prototype alert system for supporting delay awareness in complex medical teamwork such as trauma resuscitation. We used semi-structured interviews and card-sorting workshops to identify the most common delays and elicit design requirements for the prototype alert system. We then conducted a survey to refine the alert designs, followed by near-live, video-guided simulations to investigate clinicians' reactions to the alerts. We contribute to CSCW by designing a prototype alert system to support delay awareness in time-critical, complex teamwork and identifying four mechanisms through which teams mitigate delays.
- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.1145/3462204.3481746
