Systems-based framework for clinical decision-support system integration for patient sepsis management: A theoretical application of the SEIPS model

Sepsis management in the emergency department (ED) involves a complex interaction between tasks, persons, tools & technology, environment, and organizational factors. This study applied the Systems Engineering Initiative for Patient Safety (SEIPS) model to decompose and visualize the factors and their specific attributes in sepsis diagnosis and treatment in the ED. Sepsis management tasks in emergency department were defined as check for SIRS criteria (Task A); assess source of infection (Task B); treatment (Task C); and assessment of acute organ dysfunction (Task D). The SEIPS model was applied to decompose and visualize the factors (with attributes) involved in sepsis management in the emergency department. The factors include task demands (e.g., human knowledge, complexity, variety), person's resource demands (e.g., memory, attention, situation awareness), tools and technology demands (e.g., usability, functionality, automation), internal and external environments demands (e.g., light and regulations), and organizational factors demands (e.g., training). The visualizations of this framework reveal varying demands for factors and attributes across tasks, with theoretically higher demands for Task B. Task B requires extensive human resources, involves complex and ambiguous decision-making, and demands significant knowledge. Additionally, technologies with good usability were identified as essential to support clinicians in all evaluated tasks. For the organizational factor, training and education were noted as the most important attributes for sepsis care. This framework can be utilized by researchers, providers, and organizations to evaluate work system factors and their interconnections in ED, ultimately enhancing care delivery, improving patient outcomes, and increasing provider satisfaction.