Abstract
Drawing software from Lassalle Technologies1 (France) designed for Visual Basic is the tool we used to standardize the creation, storage, and retrieval of flow diagrams containing information about adverse events and close calls.
At NCPS we were faced with the goal of providing training and tools to 172+ VA healthcare facilities to enable them to perform root cause analysis (RCA) for adverse events and close calls. We began software development in summer 2000 using principles of human factors and iterative design. We elected to base the software on Microsoft Access because this is software that all of the VA healthcare facilities own and use. The database backend is SQL Server. The focus of this poster is the drawing tool that is incorporated into RCA software.
Patient Safety Managers were initially trained using a Microsoft Word template. In order to clarify thinking about adverse events they are asked to create a flow diagram and recently have also been asked to create cause and effect diagrams.
We found that managing (storing, searching, and retrieving) a collection of diagrams created in many software formats was difficult. Many end users had never used a computer to draw. Low cost drawing software from Lassalle Technologies is the tool we used to standardize the creation, storage, and retrieval of flow diagrams with information about adverse events and close calls. The ActiveX Control is designed for use with Visual Basic. Storing the data points inside an application database to allow recreation of the drawing was thought not possible. Two methods for saving the drawing were included in the original ActiveX design: a proprietary format, or an encapsulated metafile (EMF). Using the ActiveX Control with Microsoft Access is a novel use.
As adapted for use within RCA software, the drawing tool requires no training prior to first use; eliminates the difficulty of importing an object from other drawing software—and requiring the same software in order to view it; and also allows the contents of the diagram itself to be searchable. The completed diagram displays both on screen and in print form.
Figure 1.
Create Flow Chart View
Figure 2.
Resulting Cause-Effect Diagram
Reprinted from the Proceedings of the 2001 AMIA Annual Symposium, with permission.