Increasing situation awareness in healthcare through real-time simulation

Research into real-time simulation applications outside of manufacturing environments has extended to sociotechnical systems such as healthcare over the past decade, where a number of published studies have demonstrated proof-of-concept models for near-future resource planning. Using real-time decision-support systems, people take decisions supported by the output of simulations. However real-time simulation frameworks abstract human intervention to an “external decision-maker,” with little regard to the complexities of underlying decision-making constructs, and how design and development decisions can impact the quality of decision-support. One such construct is situation awareness (SA), which is a precursor to decision-making. It is a dynamic state of knowledge about how a situation is unfolding; one approach to enhancing situation awareness is the provision of appropriate real-time information. We argue that design, development and implementation decisions should be focused at the interface between decision-making and decision-support. This integrative literature review proposes a SA framework integrating models of SA with a technical perspective for real-time simulation, to support an understanding of the cognitive needs of users alongside technical details during the development process. The implications for the usefulness and usability of real-time decision-support tools are discussed with application to Emergency Departments.