Towards Optimal Communication of Patient Details in Tactical Combat Casualty Care

Abstract

Due to the increase of political friction and terrorist attacks, the Netherlands Ministry of Defence (MinDef) is preparing its armed forces for combat situations. If these occur, a large number of victims is expected in a short amount of time, which puts pressure on the military medical chain. As it is crucial to treat patients as early as possible, low resource medical treatment facilities (Role 1 MTFs) are placed near the battlefield. Heavily wounded soldiers are transported to this facility, where they are stabilised in order to survive transportation to a facility with more resources. Due to the Role 1 MTF’s critical function, it is of importance that the communication of patient details is optimal, as it improves the patient flow and survival rate. Currently, the communication of patient details causes a delay in the treatment process. This graduation project aimed for the improvement of patient detail communication by providing insight into the current communication process and formulating a vision for future innovation. By performing different research activities, such as observations and interviews, an understanding of the Role 1 MTF and the used communication methods was developed. This resulted in an overview of communication problems that affect the efficiency of care and are experienced as frustrating. The key influence of these frustrations was the lack of situational awareness (SA), which became the focus of this project. To summarise the research findings, a journey map was made. The journey map provides an overview of the events that take place within the Role 1 MTF, the communication activities, the workload, and the cognitive load as it is perceived by the general military physician (AMA). It was decided to focus on the AMA, as this person has the role of commander and has to makes the medical decisions. Design opportunities could be identified from the journey map and were used as a starting point for ideation. The ideation resulted in several design ideas, which were evaluated on their desirability and credibility. The insights obtained from this evaluation were used to formulate a future vision, which was visualised in a vision map (figure 1).
The future vision describes three innovation horizons to increase SA and improve the communication of patient details in the Role 1 MTF. The first horizon describes how process innovation could be achieved in the short term. The second horizon proposes the adaptation of available technology, which can be implemented within 15 years. The third horizon describes disruptive innovation for the far future, where the Role 1 MTF will become obsolete.
In the end, this graduation project provided a tool to evaluate the communication of patient details in the Role 1 MTF and a vision for future innovation. These tools are the outcome of user-centered research, which makes them of value for the MinDef and can support future innovation for the Role 1 MTF.