Closing the Loop by Operationalizing Systems Engineering and Design (CLOSED)
Motivation:
Specific Aims :
Aim 1:​Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for diagnostic tests and referrals that ensures diagnostic orders and follow-up occur reliably within clinically- and patient-important time-frames.
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Aim 2: Use systems engineering and patient engagement to design, develop, and refine a highly reliable “closed loop” system for symptoms that ensures clinicians receive and act on feedback about evolving symptoms and physical findings of concern to patients or clinicians.
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Aim 3: Design for generalizability across health systems more broadly so that the processes created in Aims 1 and 2 are effective in (1) a practice in an underserved community, (2) a large tele-medicine system, and (3) a representative range of simulated other health system settings and populations.
Partners:
Sunday, June 2, 2019
Sunday, June 2, 2019
Approach:
Sunday, June 2, 2019
Results to Date:
Acute Care Patient Safety Learning Lab
​As a result of increasing implementation and use of health IT and patient/family engagement in their plan of care, this PSLL is providing information, strategies, and tools for using health IT to facilitate patient activation in eliminating harm in hospital settings.
Motivation:
The goal of this learning laboratory is to develop tools to engage patients, family, and professional care team members in reliable identification, assessment, and reduction of patient safety threats in real time, before they manifest in actual harm.
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As a result of increasing implementation and use of health IT and patient/family engagement in their plan of care, this PSLL is providing information, strategies, and tools for using health IT to facilitate patient activation in eliminating harm in hospital settings.
Specific Aims :
Aim 1:​ Engage patients and their family caregivers in the design of health IT tools to prevent patient falls and related injuries during an acute hospitalization.
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Aim 2: Engage health care providers and patients in the design and development of a Patient Safety Checklist Tool to improve patient safety and quality outcomes, provider efficiency, and team communication.
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Aim 3: Iteratively develop and evaluate the impact of a patient safety reporting system on patient safety and foster a learning health system.
Partners:
Approach:
Results to Date:
Publications:
Bersani K., Fuller TE, Garabedian P, Espares J, Mlaver E, Businger A, Chang F, Boxer R, Schnock KO, Rozenblum R, Dykes PC, Dalal AK, Benneyan J, Lehmann L, Gershanik E, Bates DW, Schnipper JL (2020). Use, perceived usability, and barriers to implementation of a patient safety dashboard integrated within a vendor EHR. Appl Clin Inform, 11(1):34-45, doi: 10.1055/s-0039-3402756.
Businger A, Fuller T, Rozenblum R, Dalal A, Schnock K, Rossetti S, Schnipper J, Benneyan J, Bates B, Dykes P (2019). Lessons learned implementing a complex and innovative patient safety learning laboratory project in a large academic medical center, Journal of the American Medical Informatics Association, doi: 10.1093/jamia/ocz193
Collins S, Couture B, DeBord-Smith A, Gershanik E, Lilley E, Chang F, Yoon C, Lipsitz S, Benneyan J, Bates D (2017), Mixed-methods evaluation of real-time safety reporting by hospitalized patients and their care partners: The MySafeCare application, Journal of Patient Safety. doi: 10.1097/PTS.0000000000000493
Collins S, Couture B, Dykes P, Schnipper J, Fagan M, Benneyan J, Sheikh A, Bates D, Sordo M (2018), Implementation, evaluation, and recommendations for extension of AHRQ common formats to capture patient and care partner generated safety data, Journal of the American Medical Informatics Association, https://doi.org/10.1093/jamiaopen/ooy004.
Dalal A, Fuller T, Garabedian P, Ergai A, Balint C, Bates D, Benneyan J (2019). Systems engineering and human factors support of a system of novel EHR-integrated tools to prevent harm in the hospital, Journal of the American Medical Informatics Association, 26(6): 553-560, https://doi.org/10.1093/jamia/ocz002
Couture B, Fagan M, Gershanik E, Yoon C, Benneyan J, Bates DW, Collins SA. Towards analytics of the patient and family perspective: A case study and recommendations for data capture of safety and quality concerns. AMIA Annual Symposium Proceedings. Washington, D.C.; 2017:615-624.
Dykes P, Burns Z, Adelman J, Benneyan J, Bogaisky M, Carter E, Ergai A, Lindros M, Lipsitz S, Scanlan M, Shaykevich S, Bates D (2020). Evaluation of a patient-centered fall prevention toolkit to reduce falls and injuries: a nonrandomized controlled trial, JAMA Open, 2020;3(11):e2025889. doi:10.1001/jamanetworkopen.2020.25889.
Fuller T, Garabedian P, Lemonias D, Joyce E, Schnipper J, Harry E, Bates D, Dalal A, Benneyan J (2020). Assessing the cognitive and work load of an electronic patient safety dashboard in the context of opioid prescribing, Applied Ergonomics, 85, https://doi.org/10.1016/j.apergo.2020.103047
Katsulis Z, Ergai A, Leung W, Schenkel L, Rai A, Adelman J, Benneyan J, Bates D, Dykes P (2016), Iterative user centered design for development of a patient-centered fall prevention toolkit, Applied Ergonomics, 56:117-126.
Mlaver E, Schnipper J, Boxer R, Breuer D, Gorbovitsky G, Harry E, Gershanik E, Wolf L, Dykes P, Benneyan J, Bates D, Lehmann L (2017), User-centered collaborative design and development of an inpatient safety dashboard, Joint Commission Journal on Quality Improvement, 43(12): 676–685. http://dx.doi.org/10.1016/j.jcjq.2017.05.010
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Couture B, Lilley E, Chang F, DeBord Smith A, Cleveland J, Ergai A, Katsulis Z, Benneyan J, Gershanik E, Bates D, Collins S. Applying user-centered design methods to the development of an mHealth application for use in the hospital setting by patients and care partners, Appl Clin Inform 2018, 9(2):302-12.
Dalal A, Fuller T, Garabedian P, ,.., Benneyan J. An interdisciplinary team to support implementation of a “System-of-systems” to identify, assess, and mitigate threats to patient safety in real-time. Society of Hospital Medicine Conference. 2018, Apr 8-11.
Dalal A, Fuller T, Neri P, Breuer D, Bates D, Benneyan J (2017), Opportunities and Challenges for an Interdisciplinary Team to Guide Adoption of Technology to Dissipate Threats to Patient Safety in Real-Time, American Medical Informatics Association, Washington, DC.
Fuller T, Neri P, Lemonias D, Harry E, Schnipper J, Joyce E, Martell T, Nehls N, Bates D, Dalal A, Benneyan J (2018), Assessing the usability and cognitive load of an electronic safety dashboard in the context of opioid prescribing: Preliminary results, Human Factors and Ergonomics in Health Care, Boston, MA
Fuller T, Espares J, Duckworth M, Couture B, Schnipper J, Dykes P, Collins S, Dalal A, Rozenblum R, Schnock K, Gershanik E, Lipsitz S, Businger A, Neri P, Benneyan J, Bates D (2017) Making acute care more patient-centered: Implementing a learning lab, iHealth 2017 Clinical Informatics Conference, May 2-4, 2017, Philadelphia, PA
Fuller T, Dalal A, Breuer D, Neri P, Bates D, Benneyan J (2017), Using systems engineering methods to identify, assess, and mitigate preventable harm as part of a patient safety learning laboratory, American Medical Informatics Association, Washington, DC
Neri P, Dalal A, Fuller T, Breuer D, Ergai A, Bates D, Benneyan J (2017), Experiences implementing a user-centered design process across a large patient safety learning laboratory, American Medical Informatics Association, Washington, DC.