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Table 1 Knowledge deficits that must be addressed before the emergence of smart environments that facilitate reliable, safe, and compassionate delivery of appropriate interventions to hospitalized patients

From: Clinical review: The hospital of the future - building intelligent environments to facilitate safe and effective acute care delivery

Modality Tools Impact
Human factors and cognitive science Surveys
Field observation
Chart review
Standard ontology of error
Identify the human factors that contribute to diagnostic, rescue, or care delivery failures that result in excess morbidity and mortality in the ICU
Identify the modes of alert that are the most effective modifi ers of behavior
Ergonomics and engineering Field observation
Process modeling
Understand processes of care delivery
Identify and eliminate environmental factors that impede the delivery of care
Identify environmental artifacts that can be re-engineered to force best practice
Test the impact of changes in models of care delivery Test the impact on processes of care in high-fidelity simulation environments
Health care informatics and health information technology Data warehousing
Data mining
Social networks
Reliably capture digital signatures of patient conditions and provider actions
Build real-time feedback to systems of health care delivery (provider and manager)
Facilitate the reporting of errors
Facilitate secondary data use (for example, the analysis of large data sets from multiple care delivery settings)
Dissemination of knowledge
Culture Reporting error at a local level
Coordinated response of ICU community to error
Developing and enforcing standards
Knowledge of new or unanticipated errors
Organized response re-enforces value of reporting
Facilitate the implementation of recommendations
Reform of incentives
Perpetuate the safety culture