import React, { useMemo, useState } from 'react'; import { ChevronRight, CheckCircle2, AlertTriangle, ClipboardList, BedDouble, MonitorSmartphone, FileText, Badge, Stethoscope, Users, ArrowRight, Shield, CircleHelp, ChevronDown, ChevronUp, Map, } from 'lucide-react'; type Label = { id: string; title: string; subtitle: string; icon: React.ComponentType<{ className?: string }>; tone: string; actions: string[]; examples: string[]; }; type SignalItem = { id: string; title: string; role: string; icon: React.ComponentType<{ className?: string }>; text: string; strengths: string[]; risks: string[]; }; type DetailCard = { title: string; summary: string; detail: string; }; const labels: Label[] = [ { id: 'immediate', title: 'Immediate MDRO Precautions', subtitle: 'Known or confirmed CRO status', icon: Shield, tone: 'bg-slate-900 text-white border-slate-900', actions: [ 'Start the MDRO precautions pathway immediately.', 'Use placement and contact-precaution workflow per local policy.', 'Keep the signal visible in record, paperwork, and care environment.', ], examples: ['Known CRO history in prior records', 'Newly confirmed CRO-positive case'], }, { id: 'preemptive', title: 'Pre-emptive MDRO Precautions', subtitle: 'High-risk admission trigger', icon: AlertTriangle, tone: 'bg-slate-800 text-white border-slate-800', actions: [ 'Start precautions before lab confirmation.', 'Make the risk visible across handoff and transfer.', 'Support the clinician with the next few actions, not a long policy read.', ], examples: ['Treatment abroad >24 hours in last 12 months', 'Direct transfer from overseas hospital'], }, { id: 'standard', title: 'Standard Precautions', subtitle: 'No current MDRO trigger identified', icon: CheckCircle2, tone: 'bg-slate-700 text-white border-slate-700', actions: [ 'Continue routine workflow.', 'Do not create unnecessary MDRO friction.', 'Keep the process simple enough that staff will actually use it.', ], examples: ['No known CRO history', 'No high-risk admission trigger present'], }, ]; const signalStack: SignalItem[] = [ { id: 'record', title: 'Computer record banner', role: 'Master signal', icon: MonitorSmartphone, text: 'Persistent status in the patient record, visible at admission, transfer, and future re-admission.', strengths: ['Most durable over time', 'Best for forcing the admission decision', 'Best place to preserve the alert'], risks: ['Only works if access is reliable', 'Not enough by itself during physical movement'], }, { id: 'paper', title: 'Traveling paperwork marker', role: 'Operational backup', icon: FileText, text: 'A compact label on the admission sheet, file cover, or transfer form that follows the patient physically.', strengths: ['Visible even when digital access fails', 'Useful during handoff and transport', 'Easy to pilot quickly'], risks: ['Can be separated from the patient', 'Can be missed if the form is buried'], }, { id: 'environment', title: 'Bed / room precautions sign', role: 'Point-of-care cue', icon: BedDouble, text: 'Neutral signage at the room entrance, bed space, or curtain line to trigger the right behavior before contact.', strengths: ['Best cue for bedside behavior', 'Helps nurses, support staff, and visitors understand precautions', 'Turns the room into part of the signal system'], risks: ['Only applies once a bed space is assigned', 'Should not be the first or only signal'], }, { id: 'wristband', title: 'Patient-linked wristband', role: 'Backup patient cue', icon: Badge, text: 'A neutral band with an internal symbol or code so the signal stays on the patient if record access or paperwork fails.', strengths: ['Stays with the patient', 'Useful in movement between units', 'Helps when paperwork or records are unavailable'], risks: ['Needs training to interpret', 'Can become too subtle or too stigmatizing if poorly designed', 'Should not replace record, paper, or bed-space signals'], }, ]; const assumptions: string[] = [ 'The highest-leverage starting point is the first admission / first-assessment moment.', 'A small, action-first decision tool is more reliable than a descriptive risk category system.', 'In the first version, the admission logic should focus on what is knowable immediately, not everything that may become relevant later.', 'The hospital needs a signal system, not a single tag.', 'A wristband can be useful as a backup patient-linked cue, but it should not carry the whole workflow by itself.', 'The first pilot can assume a full-resources environment, while leaving space for later medium- and low-resource adaptations.', ]; const openQuestions: string[] = [ 'Are these admission triggers clinically appropriate as a first-pass rule set?', 'Should known CRO and newly confirmed CRO remain under one action label or be separated operationally?', 'What is the safest, least stigmatizing way to display a patient-linked signal such as a wristband?', 'At which exact point in the real admission workflow is the label assigned: triage, doctor review, nurse intake, or ward arrival?', 'Which signals are already feasible in the customer’s setting: record banner, paper marker, room sign, wristband?', 'Which downstream actions should be shown directly under each label in the first pilot?', ]; const futureRevisions: Array<{ title: string; text: string }> = [ { title: 'Medium- and low-resource variants', text: 'Once the core decision logic is validated, the same pathway can be adapted for settings with weaker digital systems, less consistent paperwork, or more limited placement options.', }, { title: 'Secondary escalation triggers', text: 'The next version can incorporate high-risk unit placement, devices, ventilation, and outbreak linkage as escalation rules after admission rather than crowding the first-pass tool.', }, { title: 'Transfer and discharge continuity', text: 'The same signal stack can be extended so MDRO status survives inter-unit transfer, discharge, and re-admission without starting from zero.', }, { title: 'Attendant / family integration', text: 'A later phase can add a small, structured instruction set for attendants so the human environment around the patient is included in the precautions pathway.', }, { title: 'Clinical decision support', text: 'Once the label system is stable, the customer could attach short action bundles, culture prompts, or transfer checklists directly to each label.', }, { title: 'Validation and audit', text: 'A future phase can define metrics such as time-to-flag, correct signal persistence, and correct first-action completion so the process can be evaluated, not just deployed.', }, ]; const problemStakeCards: DetailCard[] = [ { title: 'User', summary: 'Admitting clinician or triage / ward nurse at first contact.', detail: 'The specific person is the clinician or nurse who first receives the patient and must make an early precautions decision before the patient settles into the normal workflow.', }, { title: 'Moment', summary: 'The first 5–10 minutes of assessment.', detail: 'This is the window in which the staff member decides whether the patient should enter an MDRO precautions pathway now, before later placement, transfer, and communication decisions start to compound.', }, { title: 'Pain point', summary: 'The signal is easy to miss or lose.', detail: 'The patient can move through assessment, transport, placement, and handoff before the right precautions begin because the signal is missed, delayed, or not carried reliably across record, paper, environment, and movement.', }, ]; const whyStartCards: DetailCard[] = [ { title: 'Early enough to matter', summary: 'Admission influences downstream workflow.', detail: 'This moment can change placement, precautions, communication, and later workflow before errors are amplified downstream.', }, { title: 'Narrow enough to prototype', summary: 'It avoids redesigning everything at once.', detail: 'A pilot can focus on one reliable decision instead of taking on the entire hospital operations problem in version 1.', }, { title: 'Clinically reviewable', summary: 'A medical reviewer can check the assumptions quickly.', detail: 'The customer can react directly to the admission triggers, signal placement, and workflow timing without having to approve a huge abstract system.', }, { title: 'Reusable backbone', summary: 'Later versions can extend the same core.', detail: 'Once the admission-start signal system is validated, it can be extended into transfer, discharge, outbreak response, and lower-resource variants.', }, ]; function Pill({ children }: { children: React.ReactNode }) { return ( {children} ); } function ExpandableCard({ title, summary, children, badge, defaultOpen = false, icon: Icon, }: { title: string; summary?: string; children: React.ReactNode; badge?: string; defaultOpen?: boolean; icon?: React.ComponentType<{ className?: string }>; }) { const [open, setOpen] = useState(defaultOpen); return (
{open ?
{children}
: null}
); } function ExpandableSection({ id, title, subtitle, summary, icon: Icon, open, onToggle, children, }: { id: string; title: string; subtitle: string; summary: string; icon: React.ComponentType<{ className?: string }>; open: boolean; onToggle: (id: string) => void; children: React.ReactNode; }) { return (
{open ?
{children}
: null}
); } export default function MDROAdmissionPlanReview() { const [activeLabel, setActiveLabel] = useState('immediate'); const [openSections, setOpenSections] = useState({ problem: false, why: false, core: true, signals: false, assumptions: false, questions: false, future: false, }); const current = useMemo(() => labels.find((x) => x.id === activeLabel) || labels[0], [activeLabel]); const CurrentIcon = current.icon; const toggleSection = (id: string) => { setOpenSections((prev) => ({ ...prev, [id]: !prev[id as keyof typeof prev] })); }; return (

Customer review artifact

MDRO admission-start precautions plan

A focused starting proposal for the first-assessment moment: how an admitting doctor or nurse identifies an incoming patient who should enter an MDRO precautions pathway, how that signal stays visible, and why this is a strong place to start.

Click a section card to open it, then use the inner cards for one more level of detail.
{problemStakeCards.map((card) => (
{card.detail}
 ))}
The proposal is intentionally narrow: not solve all MDRO operations, but make the first admission-start decision more reliable.
{whyStartCards.map((card) => (
{card.detail}
 ))}
{labels.map((label) => ( ))}

{current.title}

{current.subtitle}

What staff should do
{current.actions.map((action, idx) => (
{action}
))}
Typical examples
{current.examples.map((item, idx) => (
{item}
))}
Admission decision shape
This captures patients with known CRO history in prior records and patients who are already newly confirmed as CRO-positive.
This keeps the first-pass tool focused on what is realistically knowable at admission without adding too many secondary risk factors up front.
The goal is to avoid unnecessary friction while keeping the system simple enough that clinicians and nurses will actually use it consistently.
Version 1 stays intentionally small. More complex triggers can be added later as escalation logic instead of overloading the first-pass admission decision.
{signalStack.map((item) => { const Icon = item.icon; return (
Why keep it
{item.strengths.map((s, idx) => (
{s}
))}
Limitations
{item.risks.map((s, idx) => (
{s}
))}
); })}
{assumptions.map((item, idx) => (
This assumption should be confirmed, refined, or rejected by the customer based on real workflow, staffing, and clinical constraints.
))}
{openQuestions.map((q, idx) => (
The customer’s answer should help determine whether the admission logic, signal design, or rollout path needs to change before piloting.
))}
{futureRevisions.map((item, idx) => (
This future step depends on the same core admission-start signal system being validated first, rather than designing isolated fixes for each new situation.
))}
The strategic argument is simple: a validated admission-start signal system creates a backbone that later improvements can extend. Without that backbone, every later feature becomes another isolated workaround.
); }