Improving Planning: Quantitative Evaluation of the Premortem Technique in Field and Laboratory Settings

This thesis compares different plan evaluation techniques in a series of experiments. The Premortem plan evaluation method can help people reduce overconfidence and generate more reasons a plan might not succeed. This research evaluates the extension of the Premortem to shorter planning time periods, evaluates the effectiveness with team generated and executed plans, and compares the use of this technique among individuals and teams. In Experiment 1, 52 Army Cadets operating in teams completed six time-constrained field exercises that required planning, half using the Premortem and half using a standard Military plan evaluation process. When teams used the Premortem they had fewer fouls and less fixation with no change in planning and execution time. In Experiment 2, 72 individual participants from university organizations used the Premortem Method or Worst-Case Scenario Method to evaluate their group’s plan for an engineering task. Results from Experiment 2 indicated that there was no statistically significant difference in the number of reasons and solutions generated between methods. However, the two methods had significantly different distributions of reasons and solutions across categories, indicating that the methods were prompting participants to approach the plan differently. To further examine the relative effectiveness of these two plan evaluation methods, and the influence of group dynamics, Experiment 3 compared the efficacy of the Premortem and Worst-Case Scenario Method amongst groups and individuals in face-to-face settings with a complex and unfamiliar plan. Eighty-two participants generated more reasons with the Premortem Method than the Worst-Case Scenario Method, and groups generated more solutions than individuals. The distribution of reasons was also significantly different across categories, indicating that the underlying mechanisms are changing how participants view the problem and generate reasons. These studies extend prior work by validating that the Premortem is effective in short planning horizons, demonstrating that it works for individuals and teams, and clarifying potential boundary conditions. This research advocates several directions for future research, and suggests possibility of future implementation as a virtual tool or application

Examining the learnability of auditory displays: Music, earcons, spearcons, and lyricons

Auditory displays are a useful platform to convey information to users for a variety of reasons. The present study sought to examine the use of different types of sounds that can be used in auditory displays—music, earcons, spearcons, and lyricons—to determine which sounds have the highest learnability when presented in sequences. Participants were self-trained on sound meanings and then asked to recall meanings after listening to sequences of varying lengths. The relatedness of sounds and their attributed meanings, or the intuitiveness of the sounds, was also examined. The results show that participants were able to learn and recall lyricons and spearcons the best, and related meaning is an important contributing variable to learnability and memorability of all sound types. This should open the door for future research and experimentation of lyricons and spearcons presented in auditory streams

Examining the learnability of auditory displays: Music, earcons, spearcons, and lyricons

Auditory displays are a useful platform to convey information to users for a variety of reasons. The present study sought to examine the use of different types of sounds that can be used in auditory displays—music, earcons, spearcons, and lyricons—to determine which sounds have the highest learnability when presented in sequences. Participants were self-trained on sound meanings and then asked to recall meanings after listening to sequences of varying lengths. The relatedness of sounds and their attributed meanings, or the intuitiveness of the sounds, was also examined. The results show that participants were able to learn and recall lyricons and spearcons the best, and related meaning is an important contributing variable to learnability and memorability of all sound types. This should open the door for future research and experimentation of lyricons and spearcons presented in auditory streams

Streamlining Care in Crisis: Rapid Creation and Implementation of a Digital Support Tool for COVID-19

The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they “agree” or “strongly agree” that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course

Streamlining Care in Crisis: Rapid Creation and Implementation of a Digital Support Tool for COVID-19

The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they “agree” or “strongly agree” that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course

Discharge Navigator: Implementation and Cross-Sectional Evaluation of a Digital Decision Tool for Social Resources upon Emergency Department Discharge

Introduction: Many patients have unaddressed social needs that significantly impact their health, yet navigating the landscape of available resources and eligibility requirements is complex for both patients and clinicians.  Methods: Using an iterative design-thinking approach, our multidisciplinary team built, tested, and deployed a digital decision tool called “Discharge Navigator” (edrive.ucsf.edu/dcnav) that helps emergency clinicians identify targeted social resources for patients upon discharge from the acute care setting. The tool uses each patient’s clinical and demographic information to tailor recommended community resources, providing the clinician with action items, pandemic restrictions, and patient handouts for relevant resources in five languages. We implemented two modules at our urban, academic, Level I trauma center.  Results: Over the 10-week period following product launch, between 4-81 on-shift emergency clinicians used our tool each week. Anonymously surveyed clinicians (n = 53) reported a significant increase in awareness of homelessness resources (33% pre to 70% post, P<0.0001) and substance use resources (17% to 65%, P<0.0001); confidence in accessing resources (22% to 74%, P<0.0001); knowledge of eligibility criteria (13% to 75%, P<0.0001); and ability to refer patients always or most of the time (11% to 43%, P<0.0001). The average likelihood to recommend the tool was 7.8 of 10.  Conclusion: Our design process and low-cost tool may be replicated at other institutions to improve knowledge and referrals to local community resources.&nbsp