ABSTRACT
Naturally, military hospitals must accommodate large numbers of injured soldiers in and from the battlefield in a short time period. To enhance the soldiers’ chances of survival, a significant effort has been devoted to providing a better health care environment that is able to manage uncontrolled patient volume and the variable acuity of medical encounters effectively (McNeil & Pratt, 2008). One major effort has been to provide more operating room (OR) and intensive care unit (ICU) capability to satisfy the required medical and surgical needs (for examples in Iraq, see Eastridge, Jenkins, Flaherty, Schiller, & Holcomb, 2006; Montgomery, Swiecki, & Shriver, 2005). However, this solution only addresses one aspect of the problem and does not improve the injured soldiers’ chances of survival in the battlefield, where environments are too complicated to be controlled as desired. Furthermore, in the ORs of both military and civilian hospitals, physicians must frequently make complicated clinical decisions with limited time and information while faced with a great number of competing demands and distractions (Kovacs & Croskerry, 1999; McIntyre, Stiegmann, & Eiseman, 2004). In addition, patients have often been transferred thousands of miles, passing through multiple teams of doctors at various places; for example, a severely injured U.S. soldier in the Middle East would likely travel through several hospitals in the region before ultimately returning to a hospital in the United States. During these transitions, the patient’s information with respect to medical treatments can be easily lost or corrupted. This happens often, especially in unpredictable battlefield situations (Horwitz, Krumholz, Green, & Huot, 2006).
