This project seeks to develop new displays for visually representing physiologic variables, to enhance a clinician's ability to see and rapidly respond to critical events. Unexpected incidents are common, anesthesiologists face them during 20 percent of all anesthetics. One quarter of these incidents pose significant danger to patients. Human factors research has shown that graphic displays improve an anesthesiologist's ability to detect and identify critical events. Groups which observed graphic displays saw changes 3.1 minutes sooner than those observing traditional displays. Erroneous decisions were reduced from 4.1% to 1.4% and human response times (the time used to correct the problem) were one third the original time.

The research plan is to develop a physiologic display that increases situation awareness and shortens the time needed to detect a change, diagnose the cause of the change and treat the event. The display is to provide a comprehensive view of the surgical patient's physiologic state. If some of the variables are not being monitored, the display will use models to predict "population normal" values, thus completing the physiologic picture. The physiologic icons in the display will be organized to enhance the vision of the interrelationship between organ system function. The display will highlight input/output relationships, by showing drug concentrations and accompanying physiologic changes. Simulated sounds, which accompany the display, will enhance the serial interpretation of patient variables. The display design process will be iterative, with six cycles of design, computer implementation, evaluation, critique, and redesign.

The display will be evaluated in a full-scale patient simulator environment. Twenty-four anesthesiologists will be asked to treat simulated patients in cases where 12 critical events occur. They will be asked to think aloud as they treat the critical event, so that four stages of situation awareness can be detected. At the conclusion of six of the simulation scenarios, the anesthesiologist will be asked a set of 12 questions to assess their situation awareness. Each display will be evaluated with eye-tracking to identify the parts of the display that are most useful in decision making.

The anesthesiologist "sees" the patient on the operating table through the monitoring display. The proposed research will identify the type of display, which best helps the anesthesiologists to rapidly detect physiologic changes, to make accurate diagnostic decisions, and to efficiently treat critical events. The final display should enhance patient safety during anesthesia.