Abstract:
BACKGROUND:Preventable adverse events continue to be a threat to hospitalized patients. Clinical decision support in the form of dashboards may improve compliance with evidence-based safety practices. However, limited research describes providers' experiences with dashboards integrated into vendor electronic health record (EHR) systems. OBJECTIVE:This study was aimed to describe providers' use and perceived usability of the Patient Safety Dashboard and discuss barriers and facilitators to implementation. METHODS:The Patient Safety Dashboard was implemented in a cluster-randomized stepped wedge trial on 12 units in neurology, oncology, and general medicine services over an 18-month period. Use of the Dashboard was tracked during the implementation period and analyzed in-depth for two 1-week periods to gather a detailed representation of use. Providers' perceptions of tool usability were measured using the Health Information Technology Usability Evaluation Scale (rated 1-5). Research assistants conducted field observations throughout the duration of the study to describe use and provide insight into tool adoption. RESULTS:The Dashboard was used 70% of days the tool was available, with use varying by role, service, and time of day. On general medicine units, nurses logged in throughout the day, with many logins occurring during morning rounds, when not rounding with the care team. Prescribers logged in typically before and after morning rounds. On neurology units, physician assistants accounted for most logins, accessing the Dashboard during daily brief interdisciplinary rounding sessions. Use on oncology units was rare. Satisfaction with the tool was highest for perceived ease of use, with attendings giving the highest rating (4.23). The overall lowest rating was for quality of work life, with nurses rating the tool lowest (2.88). CONCLUSION:This mixed methods analysis provides insight into the use and usability of a dashboard tool integrated within a vendor EHR and can guide future improvements and more successful implementation of these types of tools.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Bersani K,Fuller TE,Garabedian P,Espares J,Mlaver E,Businger A,Chang F,Boxer RB,Schnock KO,Rozenblum R,Dykes PC,Dalal AK,Benneyan JC,Lehmann LS,Gershanik EF,Bates DW,Schnipper JLdoi
10.1055/s-0039-3402756subject
Has Abstractpub_date
2020-01-01 00:00:00pages
34-45issue
1issn
1869-0327journal_volume
11pub_type
杂志文章abstract:BACKGROUND:Medical students may observe and subsequently perpetuate redundancy in clinical documentation, but the degree of redundancy in student notes and whether there is an association with scholastic performance are unknown. OBJECTIVES:This study sought to quantify redundancy, defined generally as the proportion o...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692402
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Early detection and efficient management of sepsis are important for improving health care quality, effectiveness, and costs. Due to its high cost and prevalence, sepsis is a major focus area across institutions and many studies have emerged over the past years with different models or novel machine learning...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1710525
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Although diagnostic error (DE) is a significant problem, it remains challenging for clinicians to identify it reliably and to recognize its contribution to the clinical trajectory of their patients. The purpose of this work was to evaluate the reliability of real-time electronic health record (EHR) reviews u...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1713750
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020. OBJECTIVE:Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pa...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1709715
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Electronic health records (EHRs) have potential to facilitate reliable communication and follow-up of test results. However, limitations in EHR functionality remain, leading practitioners to use workarounds while managing test results. Workarounds can lead to patient safety concerns and signify indications a...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-10-RA-0135
更新日期:2016-06-22 00:00:00
abstract:BACKGROUND:Kidney disease is under-documented in physician notes. The use of template-guided notes may improve physician recognition of kidney disease early in training. OBJECTIVE:The objective of this study was to determine whether a computerized inpatient renal template note with clinical decision support improves r...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-07-RA-0048
更新日期:2013-11-13 00:00:00
abstract:OBJECTIVES:Discharging patients from the Neonatal Intensive Care Unit (NICU) can be delayed for non-medical reasons including the procurement of home medical equipment, parental education, and the need for children's services. We previously created a model to identify patients that will be medically ready for discharge...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-09-RA-0114
更新日期:2016-02-24 00:00:00
abstract:BACKGROUND: Prediabetes and type 2 diabetes mellitus (T2DM) are one of the major long-term health conditions affecting global healthcare delivery. One of the few effective approaches is to actively manage diabetes via a healthy and active lifestyle. OBJECTIVES: This research is focused on early detection of prediabete...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1719043
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVES:This study evaluates the accuracy and portability of a natural language processing (NLP) tool for extracting clinical findings of influenza from clinical notes across two large healthcare systems. Effectiveness is evaluated on how well NLP supports downstream influenza case-detection for disease surveillance...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-12-RA-0211
更新日期:2017-05-31 00:00:00
abstract:BACKGROUND:In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a revised guideline on statin therapy initiation. The guideline included a 10-year risk calculation based on regression modeling, which made hand calculation infeasible. Compliance to the guideline has been su...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692186
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Smartphones are increasingly important for clinical decision support, but smartphone and Internet use are limited by cost or coverage in many settings. txt2MEDLINE provides access to published medical evidence by text messaging. Previous studies have evaluated this approach, but we found no comparisons with ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-06-RA-0024
更新日期:2012-09-06 00:00:00
abstract:BACKGROUND:Hospitals across the country are investing millions of dollars to adopt new Health Insurance Portability and Accountability Act (HIPAA)-compliant secure text messaging systems. However, in nearly all cases, these implementations are occurring without evaluation of their impact on patient care. OBJECTIVE:To ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1700868
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:Various computerized health risk appraisals (HRAs) are available, but few of them assess health-related quality of life (HRQoL) in a goal-directed framework. This study describes the user-centered development and usability testing of an innovative HRQoL module that extends a validated HRA tool in primary car...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-08-RA-0067
更新日期:2014-12-10 00:00:00
abstract::Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustaine...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2017-05-RA-0088
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:Telemonitoring of vital signs is an established option in treatment of patients with chronic heart failure (CHF). In order to allow for early detection of atrial fibrillation (AF) which is highly prevalent in the CHF population telemonitoring programs should include electrocardiogram (ECG) signals. It was th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-12-RA-0078
更新日期:2011-11-23 00:00:00
abstract:BACKGROUND:While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthca...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1620262
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND: Poor self-management of heart failure (HF) has contributed to poor health outcomes. Sensor-controlled digital games (SCDGs) integrates data from behavior-tracking sensors to trigger progress, rewards, content, and positive feedback in a digital game to motivate real-time behaviors. OBJECTIVES: To assess th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721399
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:As healthcare moves towards technology-driven population health management, clinicians must adopt complex digital platforms to access health information and document care. OBJECTIVES:This study explored information literacy, a set of skills required to effectively navigate population health information syst...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-06-RA-0083
更新日期:2017-02-15 00:00:00
abstract:OBJECTIVE:Venous thromboembolism (VTE) prophylaxis is an important consideration for hospitalized older adults, and the Padua Prediction Score (PPS) is a risk prediction tool used to prioritize patient selection. We developed an automated PPS (APPS) algorithm using electronic health record (EHR) data. This study examin...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1670678
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals and ambulatory settings, clinicians visit patients at home at different times, independent of each other. Twenty-nine percent of 10,000 homecare agencies in the United States have...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-12-RA-0106
更新日期:2014-04-30 00:00:00
abstract:BACKGROUND: Relaxation of laws and regulations around privacy and billing during the COVID-19 pandemic provide expanded opportunities to use telehealth to provide patient care at a distance. Many health systems have transitioned to providing outpatient care via telehealth; however, there is an opportunity to utilize te...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1713635
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outc...
journal_title:Applied clinical informatics
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0038-1676040
更新日期:2018-10-01 00:00:00
abstract::Patient-generated health data are coming into broader use across the health care spectrum and hold great promise as a means to improve care and health outcomes. At the same time, rapid evolution in the social media and mobile health (mHealth) market has promoted an environment in which creation and transmission of per...
journal_title:Applied clinical informatics
pub_type: 杂志文章,评审
doi:10.4338/ACI-2014-09-R-0082
更新日期:2015-01-14 00:00:00
abstract:OBJECTIVES:To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). METHODS:We employed a mixed met...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-01-RA-0014
更新日期:2015-07-08 00:00:00
abstract:OBJECTIVE:The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1678607
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:The authors investigated the impact of computerized provider order entry (CPOE) on the delivery times of analgesia and subsequent patient outcomes. We hypothesized that patients would report less pain and use less pain medications compared with the previous paper-based system. METHODS:Two groups of patients...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-12-RA-0114
更新日期:2015-09-23 00:00:00
abstract:OBJECTIVE:1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. METHODS:A literature search was conducted using MEDLINE, CINHL and the Cochrane Library...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2009-12-R-0019
更新日期:2010-08-04 00:00:00
abstract:OBJECTIVE:The Instrument for Evaluating Human-Factor Principles in Medication-Related Decision Support Alerts (I-MeDeSA) was developed recently in the US with a view towards improving considerations of human-factor principles when designing alerts for clinical decision support (CDS) systems. This study evaluated the ge...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-01-RA-0005
更新日期:2014-06-18 00:00:00
abstract:BACKGROUND:Although obesity is a growing problem, primary care physicians often inadequately address it. The objective of this study is to examine the prevalence of obesity documentation in the patient's problem list for patients with eligible body mass indexes (BMI) as contained in the patients' electronic medical rec...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-07-RA-0115
更新日期:2017-01-25 00:00:00
abstract:BACKGROUND:Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiot...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-12-RA-0209
更新日期:2017-06-20 00:00:00