Frank Drews

University of Utah | UOU · Department of Psychology

Recent extreme wildfires are motivating unprecedented evacuation planning. A critical need is to consider dire scenarios that allow less time to clear an area than required. Although these scenarios often begin with an ignition near a community, any scenario can become dire due to weather conditions, human response, technology, cascading events, an...

Purpose A pharmacy services call center (PSCC) was implemented to centralize pharmacy phone calls and reduce interruptions of dispensing activities in 7 community pharmacies of an academic health center. An evaluation was conducted to define, quantify, and compare the numbers and types of phone interruptions before and 3 months after PSCC implement...

Purpose Results of a study to determine whether reducing pharmacy phone call workload through implementation of a pharmacy services call center (PSCC) led to decreased employee workload, improved efficiency, and increased pharmacist availability for patient care are reported. Methods A pre–post study was conducted using the NASA Task Load Index (N...

Background: Health care personnel (HCP) use of personal protective equipment (PPE) reduces infectious disease transmission. However, PPE compliance remains low. The objective of this study was to better understand how HCP perceptions factor into PPE decision making as well as how organizational processes and the environment impact behavior. Metho...

Background: Hospitals use standard and transmission-based precautions, including personal protective equipment (PPE), to prevent the spread of infectious organisms. However, little attention has been paid to the potentially unique challenges of various healthcare personnel (HCP) in following precaution practices. Methods: From September through...

Background: In healthcare, the goal of personal protective equipment (PPE) is to protect healthcare personnel (HCP) and patients from body fluids and infectious organisms via contact, droplet, or airborne transmission. The critical importance of using PPE properly is highlighted by 2 potentially fatal viral infections, severe acute respiratory syn...

Objective: Determine the effectiveness of a personal protective equipment (PPE)-free zone intervention on healthcare personnel (HCP) entry hand hygiene (HH) and PPE donning compliance in rooms of patients in contact precautions. Design: Quasi-experimental, multicenter intervention, before-and-after study with concurrent controls. Setting: All...

Objective: This study samples interruption frequency in intensive care unit (ICU) settings to assess the relationship between interruptions and common patient hazards. Background: Task interruptions are accident contributors in numerous industries. Recently, studies on health care interruptions and their impact on patient hazards have received a...

Purpose The process and methods used in an impact assessment of a centralized pharmacy call center on community pharmacy employee patient safety climate perceptions, telephone distractions/interruptions, and prescription filling efficiency are described. Summary A broad-based team designed a multi-faceted, pre–post call center implementation analy...

Purpose: With electronic health records (EHRs) becoming ubiquitous, computer use in exam rooms during patient-provider interactions is commonplace. Although computer use brings many benefits to providers, and patients generally rate computer-use as having a positive impact, the use of mobile devices could eliminate existing issues, for example all...

Objective A human factors engineering-based intervention aimed at the modification of task behavior to increase adherence to best practices and the reduction of central line-associated bloodstream infections (CLABSI). The hypothesis was tested that a central line maintenance kit would improve adherence and reduce CLABSI compared with a standard, no...

Determining the most effective public warnings to issue during a hazardous environmental event is a complex problem. Three primary questions need to be answered: Who should take protective action? What is the best action? and When should this action be initiated? Warning triggers provide a proactive means for emergency managers to simultaneously an...

Determining the most effective public warnings to issue during a hazardous environmental event is a complex problem. Three primary questions need to be answered:Who should take protective action? What is the best action? andWhen should this action be initiated? Warning triggers provide a proactive means for emergency managers to simultaneously answ...

The assimilation of automation in commuter vehicles is rapidly increasing, as too are the concerns with these technologies. Human interaction with autonomous vehicles must be thoroughly researched to understand the quantification and qualification of interactive behaviors with these systems. We developed a study using a high-fidelity driving simula...

As autonomous vehicles become more prevalent in our everyday lives, we must succumb to the realities of technological deficiencies. Although a future of fully autonomous vehicles would be the pinnacle of safety and efficiency, the current reality leaves us in a transitional state requiring human interaction with autonomous systems. Therefore it is...

As the prevalence of autonomous vehicles onto the road increases, understanding the cognitive processes of the inevitably distracted driver is important. When engaged in a secondary task while driving, the driver’s limited supply of attentional resources is diminished, resulting in less attention available to process the unpredictable road ahead. W...

Objective: We conducted a literature search to examine the effects and experiences surrounding the transition from paper to electronic checklists in healthcare settings. We explore the types of electronic checklists being used in health care, how and where they were evaluated and seek to identify the successes and failures of using electronic chec...

Decision making in complex environments has been investigated in many domains, including medicine, aviation, business, and police operations. However, how incident commanders (ICs) make protective-action recommendations (PARs) to populations exposed to wildfire risks is underinvestigated. In this study we examined the effect of expertise on IC non-...

Hand hygiene is widely accepted as the best way to prevent hospital acquired infections. However, the current hand hygiene adherence rate is estimated to be 38.7%, which is unacceptably low (WHO, 2009). Many interventions to increase hand hygiene have been attempted, but their success varies greatly. The first goal of this paper is to analyze previ...

The current study evaluated a large number of health care icons that are currently in use in numerous Electronic Health Record Systems. For this purpose health care providers were asked to select icon – subject associations that best represent the icon in a multiple choice task. While in some cases a high level of agreement was identified between i...

Objective: Adherence engineering applies human factors principles to examine non-adherence within a specific task and to guide the development of materials or equipment to increase protocol adherence and reduce human error. Central line maintenance (CLM) for intensive care unit (ICU) patients is a task through which error or non-adherence to proto...

Two experiments used a spatial navigation task to study the relationship between individual differences in working memory capacity and interrupted task performance. The results of experiment one show that participants with low working memory capacity (WMC) are more susceptible to the negative effects of interruptions than participants with high WMC...

Each year wildfire incident commanders (ICs) manage thousands of events throughout the USA that often threaten life and property. In this task they make important decisions to protect both firefighters and citizens, usually under time pressure and uncertainty. Many environmental factors affect the choice and timing of the most effective protective-...

Objective: The objective was to evaluate a configural vital signs (CVS) display designed to support rapid detection and identification of physiological deterioration by graphically presenting patient vital signs data. Background: Current display technology in the intensive care unit (ICU) is not optimized for fast recognition and identification...

Providing support for high-level cognitive performance is largely missing in many decision support designs. Most development in this area is structured to minimize attention, decrease the need for deeper processing and limit intense goal-directed cognitive processing. However, from a dual process perspective, both automatic and deliberative process...

Checklists, with their goal to increase adherence to protocols, are gaining popularity in health care despite some serious limitations. Here I present adherence engineering (AE), a conceptual framework that aims to increase adherence to protocols. AE provides guidance for the development of equipment that supports the successful completion of struc...

The purpose of this chapter on human factors in critical care medical environments is to provide a systematic review of the human factors and ergonomics contributions that led to significant improvements in patient safety over the last five decades. The review will focus on issues that contributed to patient injury and fatalities and how human fact...

In this chapter, we discuss the application of human factors and ergonomics to developing effective simulation training in health care. Simulation provides a safe, effective method for training and assessing human performance. In aviation, simulation-based training and assessment has been widely used, significantly improving safety. This progress w...

This study was designed to examine how several methods for completing tasks (such as scrolling and zooming) differ when using touch screen devices. The goal of this research is to identify which methods produce the least amount of errors, and require the shortest amount of time when trying to accomplish a task. The study also aims to answer whether...

Patients spend the most time with nurses compared with other health care providers, and patient outcomes are directly related to the quality of nursing care. Unfortunately, nursing work systems are often not designed to accommodate the limits and capabilities of perceptual, cognitive, and physical processes, which can result in errors. The Institut...

The objective of this study was to identify cognitive predictors of failure to rescue among acute care oncology nurses. Fifty-seven oncology nurses were video recorded as they monitored a patient developing a life threatening non-routine event in a high fidelity acute care hospital setting, in the case of this analysis– sepsis. Nurses who had highe...

This paper presents the design of a game controller with integrated skin stretch feedback, a new form of touch feedback. This form of feedback can be used to provide directional information, as well as tactile gaming effects to a user through the input thumb joysticks. Prior testing has shown that a user can perceive and respond to single direction...

The clinical Joint Cognitive System (JCS) includes the clinicians, electronic health record (EHR), and other infrastructure that maintain control in the system in the service of accomplishing clinical goals. The purpose of this study is to examine the relationship between levels of control using the COCOM model (scrambled, opportunistic, tactical,...

This study examines the effects of contextual similarity or dissimilarity of interruptions during task performance. Participants engaged in a series of working memory tasks using a computer interface. While performing these tasks they were intermittently interrupted and required to perform a different task. Each participant was interrupted with fou...

Entire industries have grown up around the physiological, cognitive, and economic demands of technology on users, but there is little research into the specific psychological processes and implications of the social function of human-computer interaction (HCI), especially when the computer is programmed to mimic human norms. To understand this issu...

Aviation’s successful use of Decision Support Systems (DSS) has not been replicated in the healthcare subset of DSS referenced as Clinical Decision Support (CDS). Here the domains of healthcare and aviation are compared and contrasted providing an overview of the adaptation of lessons learned in aviation to healthcare. We propose there are differen...

Performing two cognitive tasks at the same time can degrade performance for either domain-general reasons (e.g., both tasks require attention) or domain-specific reasons (e.g., both tasks require visual working memory). We tested predictions of these two accounts of interference on the task of driving while using language, a naturally occurring dua...

Checklists and protocols have been successfully introduced into aviation with improved safety as a result of this effort. In recent years there have been attempts to introduce protocols and checklists to health care with the goal of improving patient safety. The present study investigates adherence to protocols in the intensive care unit (ICU) in a...

Use of current health care equipment for medical procedures (e.g., central line insertions and central line care) is primarily dependent on the cognition of the health care worker. That is, the present design of equipment (typically numerous, separately packaged individual items) provides minimal information about the optimal order of procedure ste...

Driver distraction is a significant source of motor-vehicle accidents. This chapter begins by presenting a framework for conceptualizing the different sources of driver distraction associated with multitasking. Thereafter, the primary focus is on cognitive sources of distraction stemming from the use of a cell phone while driving. We present conver...

Improving community resiliency to wildfire is a challenging problem in the face of ongoing development in fire-prone regions. Evacuation and shelter-in-place are the primary options for reducing wildfire casualties, but it can be difficult to determine which option offers the most protection in urgent scenarios. Although guidelines and policies hav...

This study tests how information is encoded into working memory when the type of instruction is incongruent with a task. To determine where information is encoded in working memory interruptions will be used to disrupt performance. A spatial Lego® construction task and a verbal letter arrangement task will be compared. Operation Span will be measur...

Technological innovations including software applications and the internet have increased the ability to collect and store information. However, the increasing amounts of information are used by operators who are constrained by their limited cognitive processing capacity. One common approach to improve the search for information in digital displays...

Mobile devices (e.g., smartphones, personal digital assistants, and tablets) are evolving rapidly and growing exponentially in multiple facets around the globe. Specifically, mobile devices can be used as audio and video chat, reference guide, training tool, handoff facilitation, and decision support. Undoubtedly, there are clear advantages of leve...

Cell phone use while driving has been shown to significantly impair driving performance. A limitation of current work on driver distraction, however, is that none of the research has been able to clearly measure the cognitive demand of the conversation in which a driver engages. Precise measurement of different levels of cognitive demand will impro...

The Department of Veterans Affairs (VA) health care system currently includes 152 medical centers, with at least one in each state, Puerto Rico, and the District of Columbia. VA operates more than 1,400 sites of care, including 909 ambulatory care and community-based outpatient clinics, 135 community living centers (nursing homes), 47 residential r...

In the ICU, an extensive array of variables from the hemodynamic monitoring display is routinely analyzed. However, the development of new display technologies is proceeding without adequate study of the monitoring tasks and behaviors of a primary user group--critical-care nurses. Semistructured interviews focusing on the cognitive aspects of the h...

The Problem. Driver distraction is a leading cause of motor vehicle accidents, accounting for up to 25% of crashes on the roadway. Multitasking activities, such as concurrent use of a cell phone while driving, are increasingly becoming a significant source of such distraction. Role of Driving Simulators. Driving simulators provide an important rese...

We present a novel user-centric visual analytics system that supports investigation of simulated disease outbreak and the study of decision-making. We developed Epinome as part of our research on decision making in public health and in particular, on the evaluation of information search strategies in public health practice. Epinome is a highly dyna...

Eighty-five percent of the 137 million cell phone subscribers in the United States use their phone while driving. We report four experiments that assessed the effects of hands-free cell phone conversations on simulated driving. Our first study used a car-following paradigm and found that these conversations impaired driver's reactions to vehicles b...

This study examined the impact of using an acoustic turn-by-turn navigation device on wayfinding. Participants used a driving simulator to traverse the same route twice. They either traveled both times without the guidance or used a turn-by-turn navigation on the first drive and then replicating the route from memory on the second drive. Wayfinding...

Previous research on interruptions generally investigates the effect an interruption has during the execution phase of a task. This paper investigates the effects of interruptions which are similar (a planning interruption) or dissimilar (a non-planning interruption) and are presented during the planning phase of a task. Results confirm that interr...

System control is a challenge in many everyday activities and professional contexts. Unfortunately, it is not clear how much of the cognitive demand of controlling a system depends on the specific type of the system under control. This question is especially important for comparisons between natural and technical systems. The current study examines...

Efforts to improve the delivery of health care have led scholars to look to other safety-critical industries for comparisons that may serve as models. We flesh out one popular comparison: aviation, an industry made exceptionally safe in large part due to the efforts of applied experimental and applied social psychologists. A number of aspects of th...

Agent-based models have yielded important insights regarding the transmission dynamics of communicable diseases. To better understand how these models can be used to study decision making of public health officials, we developed a computer program that linked an agent-based model of pertussis with an agent-based model of public health management. T...

Background: Simulation methods have been used extensively to model the spread and control of infectious diseases in human populations. However, they have rarely been used to help inform policy decisions related to controlling outbreaks. Public health decision support tools are still in their infancy and much remains to be learned about the advant...

Disease outbreaks affect millions of Americans every year and have potentially large health and financial costs. State and local health departments in conjunction with the CDC have the responsibility for investigating and managing disease outbreaks. Individual states define dozens of diseases as reportable. To manage the scope and diversity of thes...

This research aims to identify the impact of text messaging on simulated driving performance. In the past decade, a number of on-road, epidemiological, and simulator-based studies reported the negative impact of talking on a cell phone on driving behavior. However, the impact of text messaging on simulated driving performance is still not fully und...

Laboratory testing informs decisions triggering infectious disease investigation. Much attention has been given to surveillance for infectious diseases, and public health agencies are investing heavily in preparation for a possible pandemic H1N5 avian influenza outbreak or bioterrorist event. Media coverage on SARS, anthrax, Salmonella, measles, mu...

Background: We developed a computer program which integrated agent-based models of pertussis transmission and public health management. The program included an interface that allowed the user to interactively set policies or make individual cases decisions within a dynamic, stochastic setting and a logging system to record the decisions made. The o...

The decision of whether to evacuate or shelter-in-place SIP in a wildfire poses a significant challenge for emergency managers and residents in fire-prone areas. Events such as the 2007 Witch Creek Fire and 2008 Tea Fire in California highlight the option and viability of SIP, as well as the conflict that can occur between first-responders and resi...

This study examines how conversing with passengers in a vehicle differs from conversing on a cell phone while driving. We compared how well drivers were able to deal with the demands of driving when conversing on a cell phone, conversing with a passenger, and when driving without any distraction. In the conversation conditions, participants were in...

PURPOSE:Actual or potential adverse medical device events are a recognized, incompletely understood problem in the intensive care unit (ICU). Error-producing conditions (i.e., task interruptions) in the ICU can impact task performance and contribute to adverse medical device events. We developed a tablet computer-based tool to capture nursing task...

Unexpected incidents are common in intensive care medicine. One of the means to detect, diagnose and treat these events is physiological displays, which show the vital signs of a patient. Current monitors in the Intensive Care Unit (ICU) provide numerical and waveform data. The present project focused on determining the problems and needs of ICU nu...

Part task training (PTT) focuses on dividing complex tasks into components followed by intensive concentrated training on individual components. Variable priority training (VPT) focuses on optimal distribution of attention when performing multiple tasks simultaneously with the goal of flexible allocation of attention. This study explored how princi...

Unexpected incidents are common in intensive care medicine. One means of detecting, diagnosing, and treating these events is use of physiologic displays that show the patients’ vital signs. Monitors currently in use in intensive care units (ICUs) provide information in numerical and waveform formats, but most such displays originated in patient mon...

Up to 98,000 patients die because of human error in U.S. hospitals each year. Among the areas where errors occur frequently is the intensive care unit (ICU). Despite the impact of these errors, little research has identified the human factors that contribute to errors in the ICU. The current study uses the error-producing conditions (EPC) approach...

Up to 98,000 patients die annually in U.S. hospitals due to human error. Despite epidemiological studies demonstrating the severity of this problem it is still unclear what the contributing factors to human error are. However, in aviation one contributor to accidents is task interruptions. The present study examined the frequency and impact of task...

To lay the foundation for a framework of just-in-time support (JITS) for novices dealing with urgent, unfamiliar tasks, and to evaluate a JITS system. More than 350,000 people die annually of cardiac arrest in the United States. In response, automated defibrillators are advocated that, unfortunately, do not provide important respiratory support. Th...

Our research examined the effects of hands-free cell-phone conversations on simulated driving. We found that even when participants looked directly at objects in the driving environment, they were less likely to create a durable memory of those objects if they were conversing on a cell phone. This pattern was obtained for objects of both high and l...

To evaluate the data quality of ventilator settings recorded by respiratory therapists using a computer charting application and assess the impact of incorrect data on computerized ventilator management protocols. DESIGN An analysis of 29,054 charting events gathered over 12 months from 678 ventilated patients (1,736 ventilator days) in four intens...

Computerized Provider Order Entry (CPOE) with electronic documentation, and computerized decision support dramatically changes the information environment of the practicing clinician. Prior work patterns based on paper, verbal exchange, and manual methods are replaced with automated, computerized, and potentially less flexible systems. The objectiv...

Authors developed a picture-graphics display for pulmonary function to present typical respiratory data used in perioperative and intensive care environments. The display utilizes color, shape and emergent alerting to highlight abnormal pulmonary physiology. The display serves as an adjunct to traditional operating room displays and monitors. To ev...

More than 300,000 people die from sudden cardiac arrest (SCA) annually in the United States. As professional responders such as EMTs make efforts to expedite their arrival, critical minutes pass jeopardizing the victim's health. Providing life-sustaining intervention in the first few minutes greatly contributes to healthier outcomes. Often, there a...

Our research examined the effects of hands-free cell phone conversations on the encoding of traffic-related information while operating a motor vehicle. We recorded event-related brain potentials (ERPs) time-locked to the onset of a lead vehicle's brake lights while participants drove in a high-fidelity driving simulator. Compared to single-task dr...

To review the literature on data displays in anesthesia identifying issues and developing design recommendations. Unexpected incidents are common in critical care medicine. Adverse outcomes are frequently the catastrophic endpoints of an "evolving" chain of subtle incidents. One strategy to reduce the likelihood of an adverse patient outcome during...

The objective of this research was to determine the relative impairment associated with conversing on a cellular telephone while driving. Epidemiological evidence suggests that the relative risk of being in a traffic accident while using a cell phone is similar to the hazard associated with driving with a blood alcohol level at the legal limit. The...

To conceptualize delivery of anesthesia as a control task, similar to control tasks in nonmedical domains, and to evaluate how presentation of new information and feedback affects task performance. In anesthesia, integrated monitors that show intravenous drug and effect-site concentrations in a patient currently do not exist. However, using real-ti...

Enhanced training techniques have been successfully employed to improve performance in domains that require efficient multi-tasking skills. Some of these techniques include part task training (PTT) and variable priority training (VPT). PTT focuses on dividing complex tasks into small components followed by intensive concentrated training on each in...

As our civilization continues to dive deeper into the information age, making sense of complex data becomes critical. This work takes on this challenge by means of a novel method based on complete interdisciplinarity, design process and built-in evaluations. The result is the design, construction, testing and deployment of data environments support...

Our research examined the effects of hands-free cell phone conversations on simulated driving. We found that even when participants looked directly at objects in the driving environment, they were less likely to create a durable memory of those objects if they were conversing on a cell phone. Moreover, this pattern was obtained for objects of both...

A multi-disciplinary team developed and evaluated a graphical pulmonary display to support anesthesiologist's treatment of pulmonary complications. The design process incorporated central findings from the areas of naturalistic decision-making and medical cognition, and used rapid iterative prototyping. To evaluate performance when using the pulmon...

Our research examined the effects of hands-free cell phone conversations on simulated driving. We found that driving performance of both younger and older adults was influenced by cell phone conversations. Compared with single-task (i.e., driving-only) conditions, when drivers used cell phones their reactions were 18% slower, their following distan...

We used a high-fidelity driving simulator to compare the performance of cell-phone drivers with drivers who were legally intoxicated from ethanol. When drivers were conversing on either a hand-held or hands-free cell-phone, their braking reactions were delayed and they were involved in more traffic accidents than when they were not conversing on th...