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Park J, Jeon H, Choi EK. Digital health intervention on patient safety for children and parents: A scoping review. J Adv Nurs 2024; 80:1750-1760. [PMID: 37950382 DOI: 10.1111/jan.15954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
AIM To explore digital health interventions on patient safety for children and their parents. DESIGN A scoping review. METHODS The PCC 'Participants, Concepts, and Contexts' guided the selection of studies that focused on children under 19 years of age or their parents, patient safety interventions for children, and digital health technology for patient safety interventions. This study was conducted using the Arksey and O'Malley framework's five steps. We reported the review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. DATA SOURCES PubMed, CINAHL, Embase, Web of Science, and Cochrane were searched for articles published up to November 2022. RESULTS A total of 13 articles were included and categorized according to the following criteria to describe the results: intervention characteristics, type of digital technology, and outcome characteristics. Regarding intervention characteristics, we identified two categories, prevention and risk management. Additionally, we identified four types of digital technology, mobile applications, web-based technologies, computer kiosks and electronic health records. Finally, in studies focussing on child safety, parental safety behaviours were used to assess injury risk or detect changes related to prevention. CONCLUSION Patient safety interventions provided through appropriate digital technologies should be developed to enhance continuum of care for children from hospitalization to home after discharge. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Digital health interventions can bolster the role of healthcare providers in patient safety in and out of hospitals, thus improving children's safety and quality of care. IMPACT What problem did the study address? Although the various advantages of digital health technology have been demonstrated, the potential role of digital technology in patient safety interventions for children has not been explored. What were the main finding? Preventive patient safety interventions and risk management for children have been developed. Where and on whom will the research have an impact? Digital health interventions on patient safety can improve children's safety and quality of care by promoting non-face-to-face engagement of children and parents after discharge and expanding healthcare providers' roles. TRIAL AND PROTOCOL REGISTRATION Registered on the Open Science Framework (https://osf.io/dkvst). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jisu Park
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Heejung Jeon
- Department of Nursing, Graduate School, Yonsei University, Seoul, South Korea
| | - Eun Kyoung Choi
- College of Nursing, Yonsei University, Seoul, South Korea
- Mo-Im Kim Nursing Research Institute College of Nursing, Yonsei University, Seoul, South Korea
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Bradford A, Shahid U, Schiff GD, Graber ML, Marinez A, DiStabile P, Timashenka A, Jalal H, Brady PJ, Singh H. Development and Usability Testing of the Agency for Healthcare Research and Quality Common Formats to Capture Diagnostic Safety Events. J Patient Saf 2022; 18:521-525. [PMID: 35443253 PMCID: PMC9391254 DOI: 10.1097/pts.0000000000001006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A lack of consensus around definitions and reporting standards for diagnostic errors limits the extent to which healthcare organizations can aggregate, analyze, share, and learn from these events. In response to this problem, the Agency for Healthcare Research and Quality (AHRQ) began the development of the Common Formats for Event Reporting for Diagnostic Safety Events (CFER-DS). We conducted a usability assessment of the draft CFER-DS to inform future revision and implementation. METHODS We recruited a purposive sample of quality and safety personnel working in 8 U.S. healthcare organizations. Participants were invited to use the CFER-DS to simulate reporting for a minimum of 5 cases of diagnostic safety events and then provide written and verbal qualitative feedback. Analysis focused on participants' perceptions of content validity, ease of use, and potential for implementation. RESULTS Estimated completion time was 30 to 90 minutes per event. Participants shared generally positive feedback about content coverage and item clarity but identified reporter burden as a potential concern. Participants also identified opportunities to clarify several conceptual definitions, ensure applicability across different care settings, and develop guidance to operationalize use of CFER-DS. Findings led to refinement of content and supplementary materials to facilitate implementation. CONCLUSIONS Standardized definitions of diagnostic safety events and reporting standards for contextual information and contributing factors can help capture and analyze diagnostic safety events. In addition to usability testing, additional feedback from the field will ensure that AHRQ's CFER-DS is useful to a broad range of users for learning and safety improvement.
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Affiliation(s)
- Andrea Bradford
- From the Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Umber Shahid
- From the Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Gordon D. Schiff
- Center for Patient Safety Research and Practice, Brigham and Women’s Hospital
- Harvard Medical School Center for Primary Care, Boston, Massachusetts
| | - Mark L. Graber
- Society to Improve Diagnosis in Medicine, Chicago, Illinois
| | - Abigail Marinez
- From the Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Paula DiStabile
- Agency for Healthcare Research and Quality, Rockville, Maryland
| | | | - Hamid Jalal
- Agency for Healthcare Research and Quality, Rockville, Maryland
| | | | - Hardeep Singh
- From the Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine
- Department of Medicine, Baylor College of Medicine, Houston, Texas
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Schnock KO, Snyder JE, Gershanik E, Lipsitz S, Dykes PC, Bates DW, Rossetti SC. Unique Patient-Reported Hospital Safety Concerns With Online Tool: MySafeCare. J Patient Saf 2022; 18:e33-e39. [PMID: 32175964 PMCID: PMC9472792 DOI: 10.1097/pts.0000000000000697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Hospitalized patients and their care partners have valuable and unique perspectives of the medical care they receive. Direct and real-time reporting of patients' safety concerns, though limited in the acute care setting, could provide opportunities to improve patient care. METHODS We implemented the MySafeCare (MSC) application on six acute care units for 18 months as part of a patient-centered health information technology intervention to promote engagement and safety in the acute care setting. The web-based application allowed hospitalized patients to submit safety concerns anonymously and in real time. We describe characteristics of patient submissions including their categorizations. We evaluated rates of submissions to MSC and compared them with rates of submissions to the Patient Family Relations department at the hospital. In addition, we performed thematic analysis of narrative concerns submitted to the application. RESULTS We received 46 submissions to MSC and 33% of concerns received were anonymous. The overall rate of submissions was 0.6 submissions per 1000 patient-days and was considerably lower than the rate of submissions to the Patient Family Relations during the same period (4.1 per 1000 patient-days). Identified themes of narrative concerns included unmet care needs and preferences, inadequate communication, and concerns about safety of care. CONCLUSIONS Although the submission rate to the application was low, MSC captured important content directly from hospitalized patients or their care partners. A web-based patient safety reporting tool for patients should be studied further to understand patient and care partner use and willingness to engage, as well as potential effects on patient safety outcomes.
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Affiliation(s)
- Kumiko O. Schnock
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
- Harvard Medical School, Boston, Massachusetts
| | - Julia E. Snyder
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
| | - Esteban Gershanik
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
- Harvard Medical School, Boston, Massachusetts
| | - Stuart Lipsitz
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
- Harvard Medical School, Boston, Massachusetts
| | - Patricia C. Dykes
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
- Harvard Medical School, Boston, Massachusetts
| | - David W. Bates
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital
- Harvard Medical School, Boston, Massachusetts
| | - Sarah Collins Rossetti
- Department of Biomedical Informatics, Columbia University, New York, New York
- School of Nursing, Columbia University, New York, New York
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Comparative Effectiveness of Pediatric Integrative Medicine: A Pragmatic Cluster-Controlled Trial. CHILDREN-BASEL 2021; 8:children8040311. [PMID: 33923869 PMCID: PMC8072575 DOI: 10.3390/children8040311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022]
Abstract
Symptoms of pain, nausea/vomiting, and anxiety (PNVA) are highly prevalent in pediatric inpatients. Poorly managed symptoms can lead to decreased compliance with care, and prolonged recovery times. Pharmacotherapy used to manage PNVA symptoms is of variable effectiveness and carries safety risks. Complementary therapies to manage these symptoms are gaining popularity due to their perceived benefits and low risk of harm. Pediatric integrative medicine (PIM) is the combination of complementary therapies with conventional medicine in pediatric populations. A two-arm, cluster-controlled, pragmatic clinical trial was carried out to compare the effectiveness of a PIM service in conjunction with usual care, versus usual care only to treat PNVA symptoms in hospitalized pediatric patients. The primary outcome was the improvement of PNVA symptom severity using a 10-point numerical rating scale. Participant enrollment occurred between January 2013 and January 2016. A total of 872 participants (usual care n = 497; PIM n = 375) were enrolled. The PIM therapies significantly reduced PNVA symptom severity (p < 0.001). This study found that a hospital-based PIM service is both safe and effective for alleviating PNVA symptoms. Future research should carry out this work in other pediatric inpatient divisions, and in other sites to determine the reproducibility of findings.
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Al-Barnawi A, He Y, Maglaras LA, Janicke H. Electronic medical records and risk management in hospitals of Saudi Arabia. Inform Health Soc Care 2018; 44:189-203. [PMID: 29584517 DOI: 10.1080/17538157.2018.1434181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Electronic medical records systems and the associated risks have been well studied in developed countries; the same cannot be said for systems in developing countries. Previous research in Saudi Arabian health-care organizations has shown a low level of quality in hospital services due to ineffective risk management. The objective of this research is to apply the Systems Theoretic Accident Modelling and Processes (STAMP) risk management technique in Saudi Arabia and evaluate its implementation. PARTICIPANTS The participating organization is a health-care organization in Saudi Arabia Methods: A two-phase case study was conducted. The first phase implemented the STAMP technique to identify and manage risks to the system. For the second phase, the STAMP technique was extended to include a checklist, to increase STAMP's capability to mitigate risks, and the process reapplied. RESULTS AND CONCLUSION The results demonstrated that the inclusion of the STAMP Checklist reduced errors and prevented system failures compared to regular STAMP.
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Affiliation(s)
- Abdullah Al-Barnawi
- a School of Computer Science and Informatics , De Montfort University , Leicester, UK
| | - Ying He
- a School of Computer Science and Informatics , De Montfort University , Leicester, UK
| | - Leandros A Maglaras
- a School of Computer Science and Informatics , De Montfort University , Leicester, UK
| | - Helge Janicke
- a School of Computer Science and Informatics , De Montfort University , Leicester, UK
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Gong Y, Kang H, Wu X, Hua L. Enhancing Patient Safety Event Reporting. A Systematic Review of System Design Features. Appl Clin Inform 2017; 8:893-909. [PMID: 28853766 DOI: 10.4338/aci-2016-02-r-0023] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/25/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Electronic patient safety event reporting (e-reporting) is an effective mechanism to learn from errors and enhance patient safety. Unfortunately, the value of e-reporting system (a software or web server based platform) in patient safety research is greatly overshadowed by low quality reporting. This paper aims at revealing the current status of system features, detecting potential gaps in system design, and accordingly proposing suggestions for future design and implementation of the system. METHODS Three literature databases were searched for publications that contain informative descriptions of e-reporting systems. In addition, both online publicly accessible reporting forms and systems were investigated. RESULTS 48 systems were identified and reviewed. 11 system design features and their frequencies of occurrence (Top 5: widgets (41), anonymity or confidentiality (29), hierarchy (20), validator (17), review notification (15)) were identified and summarized into a system hierarchical model. CONCLUSIONS The model indicated the current e-reporting systems are at an immature stage in their development, and discussed their future development direction toward efficient and effective systems to improve patient safety.
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Sousa VEC, Dunn Lopez K. Towards Usable E-Health. A Systematic Review of Usability Questionnaires. Appl Clin Inform 2017; 8:470-490. [PMID: 28487932 PMCID: PMC6241759 DOI: 10.4338/aci-2016-10-r-0170] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/26/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen. OBJECTIVES To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality. METHODS We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table. RESULTS Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7). CONCLUSIONS Existing questionnaires provide a foundation for research on e-health usability. However, future research is needed to broaden the coverage of the usability attributes and psychometric properties of the available questionnaires.
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Affiliation(s)
- Vanessa E C Sousa
- Vanessa E. C. Sousa, PhD, MSN, University of Illinois at Chicago, College of Nursing, Department of Health Systems Science, 845 South Damen St., Chicago, IL 60612, , Phone: 773-814-0517
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Vohra S, Schlegelmilch M, Jou H, Hartfield D, Mayan M, Ohinmaa A, Wilson B, Spavor M, Grundy P. Comparative effectiveness of pediatric integrative medicine as an adjunct to usual care for pediatric inpatients of a North American tertiary care centre: A study protocol for a pragmatic cluster controlled trial. Contemp Clin Trials Commun 2016; 5:12-18. [PMID: 29740618 PMCID: PMC5936744 DOI: 10.1016/j.conctc.2016.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/17/2016] [Accepted: 11/22/2016] [Indexed: 11/20/2022] Open
Abstract
Background Some pediatric tertiary care centres in North America supplement conventional care with complementary therapies, together known as pediatric integrative medicine (PIM). Evidence to support the safety and efficacy of PIM is emerging, but the cost-effectiveness of an inpatient PIM service has yet to be assessed. Methods/Design This study is a pragmatic cluster controlled clinical trial. Usual care will be compared to usual care augmented with PIM in three pediatric divisions; oncology, general medicine, and cardiology at one large urban tertiary care Canadian Children's Hospital. The primary outcome of the feasibility study is enrolment; the primary outcome of the main study is cost-effectiveness. Other secondary outcomes include the prevalence and severity of key symptoms (i.e. pain, nausea/vomiting and anxiety), efficacy of PIM interventions, patient safety, and parent satisfaction. Discussion This trial will be the first to evaluate the comparative effectiveness, both clinical and cost, of a PIM inpatient service. The evidence from this study will be useful to families, clinicians and decision makers, and will describe the clinical and economic value of PIM services for pediatric patients admitted to hospital.
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Affiliation(s)
- Sunita Vohra
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, AB T6G 2C8, Canada
- Corresponding author.
| | - Michael Schlegelmilch
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, AB T6G 2C8, Canada
| | - Hsing Jou
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, AB T6G 2C8, Canada
| | - Dawn Hartfield
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-597 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9, Canada
| | - Maria Mayan
- Community-University Partnership, Faculty of Extension, University of Alberta, 2-281 Enterprise Square, 10230 Jasper Avenue, Edmonton, AB T5J 4P6, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Institute of Health Economics, 1200 10405 Jasper Avenue, Edmonton, AB T5J 3N4, Canada
| | - Bev Wilson
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-516 Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Maria Spavor
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-529 Edmonton Clinic Health Academy, 11405 87 Ave NW, Edmonton, AB T6G 1C9, Canada
| | - Paul Grundy
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, 3-469 Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, AB, T6G 1C9, Canada
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Etchegaray JM, Ottosen MJ, Aigbe A, Sedlock E, Sage WM, Bell SK, Gallagher TH, Thomas EJ. Patients as Partners in Learning from Unexpected Events. Health Serv Res 2016; 51 Suppl 3:2600-2614. [PMID: 27778321 DOI: 10.1111/1475-6773.12593] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IMPORTANCE Patient safety experts believe that patients/family members should be involved in adverse event review. However, it is unclear how aware patients/family members are about the causes of adverse events they experienced. OBJECTIVE To determine whether patients/family members interviewed could identify at least one contributing factor for the event they experienced. Secondary objectives included understanding the way patients/family members became aware of adverse events, the types of contributing factors patients/family members identified for different types of adverse events, and recommendations provided by patients/family members to address the contributing factors. DESIGN We interviewed patients/family members using semistructured interviews to understand their perceptions about why these adverse events occurred. The adverse events occurred between 1991 and 2014. SETTING Participants described adverse events that occurred in various types of health care organizations (i.e., hospitals, ambulatory facilities/clinics, and dental clinics). PARTICIPANTS We interviewed 72 patients and family members who each described a unique adverse event. Eligibility requirements were that patients/family members spoke English or Spanish and were aware of an adverse event that happened to them or a loved one. INTERVENTION(S) FOR CLINICAL TRIALS OR EXPOSURE(S) FOR OBSERVATIONAL STUDIES: N/A. MAIN OUTCOME(S) AND MEASURE(S) The main outcome was determining whether patients/family members could identify at least one contributing factor they perceived as related to the adverse event they described. RESULTS Each participant identified at least one contributing factor and on average identified 3.67 contributing factors for their event. The most frequently mentioned contributing factors were Staff Qualifications/Knowledge (79 percent), Safety Policies/Procedures (74 percent), and Communication (64 percent). Participants knew about the contributing factors from personal observation only (32 percent), personal reasoning (11 percent), personal research (7 percent), record review (either their own medical records or reports they received in their own investigation; 6 percent), and being told by a physician (5 percent). Finally, patients/family members were able to provide recommendations that address each of the nine contributing factors we examined. CONCLUSIONS AND RELEVANCE Patients/family members identified contributing factors related to their adverse event. Given that these contributing factors might not be known to health care organizations because most participants stated that they were not involved in the analysis process, opportunities for organizational learning from patients are potentially being missed. Health care organizations should interview patients/family about the event that harmed them to help ensure a full understanding of the causes of the event.
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Affiliation(s)
| | - Madelene J Ottosen
- UT-MH Center for Healthcare Quality and Safety, McGovern Medical School, Department of Family Health, School of Nursing, University of Texas Health Science Center at Houston, Houston, TX
| | - Aitebureme Aigbe
- University of Texas Health Science Center at Houston, Houston, TX
| | - Emily Sedlock
- The University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, McGovern Medical School, UT Health Science Center at Houston, Houston, TX
| | - William M Sage
- School of Law and Dell Medical School, The University of Texas at Austin, Austin, TX
| | - Sigall K Bell
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.,Institute of Professionalism and Ethical Practice, Boston Children's Hospital BIDMC, Boston, MA
| | - Thomas H Gallagher
- Department of Bioethics and Humanities University of Washington, Seattle, WA
| | - Eric J Thomas
- McGovern Medical School at The University of Texas Health Science Center at Houston, University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, Houston, TX
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Ribeiro-Vaz I, Silva AM, Costa Santos C, Cruz-Correia R. How to promote adverse drug reaction reports using information systems - a systematic review and meta-analysis. BMC Med Inform Decis Mak 2016; 16:27. [PMID: 26926375 PMCID: PMC4772685 DOI: 10.1186/s12911-016-0265-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 02/24/2016] [Indexed: 01/11/2023] Open
Abstract
Background Adverse drug reactions (ADRs) are a well-recognized public health problem and a major cause of death and hospitalization in developed countries. The safety of a new drug cannot be established until it has been on the market for several years. Keeping drug reactions under surveillance through pharmacovigilance systems is indispensable. However, underreporting is a major issue that undermines the effectiveness of spontaneous reports. Our work presents a systematic review on the use of information systems for the promotion of ADR reporting. The aim of this work is to describe the state of the art information systems used to promote adverse drug reaction reporting. Methods A systematic review was performed with quantitative analysis of studies describing or evaluating the use of information systems to promote adverse drug reaction reporting. Studies with data related to the number of ADRs reported before and after each intervention and the follow-up period were included in the quantitative analysis. Results From a total of 3865 articles, 33 articles were included in the analysis; these articles described 29 different projects. Most of the projects were on a regional scale (62 %) and were performed in a hospital context (52 %). A total of 76 % performed passive promotion of ADR reporting and used web-based software (55 %). A total of 72 % targeted healthcare professionals and 24 % were oriented to patient ADR reporting. We performed a meta-analysis of 7 of the 29 projects to calculate the aggregated measure of the ADR reporting increase, which had an overall measure of 2.1 (indicating that the interventions doubled the number of ADRs reported). Conclusions We found that most of the projects performed passive promotion of ADR reporting (i.e., facilitating the process). They were developed in hospitals and were tailored to healthcare professionals. These interventions doubled the number of ADR reports. We believe that it would be useful to develop systems to assist healthcare professionals with completing ADR reporting within electronic health records because this approach seems to be an efficient method to increase the ADR reporting rate. When this approach is not possible, it is essential to have a tool that is easily accessible on the web to report ADRs. This tool can be promoted by sending emails or through the inclusion of direct hyperlinks on healthcare professionals’ desktops.
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Affiliation(s)
- Inês Ribeiro-Vaz
- Northern Pharmacovigilance Centre, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450, Porto, Portugal. .,Center for Health Technology and Service Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal.
| | - Ana-Marta Silva
- Northern Pharmacovigilance Centre, Faculty of Medicine, University of Porto, Rua Doutor Plácido da Costa, 4200-450, Porto, Portugal. .,Center for Health Technology and Service Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal.
| | - Cristina Costa Santos
- Center for Health Technology and Service Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal. .,Health Information and Decision Sciences Department (CIDES), Faculty of Medicine of the University of Porto, Rua Doutor Plácido da Costa, 4200-450, Porto, Portugal.
| | - Ricardo Cruz-Correia
- Center for Health Technology and Service Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal. .,Health Information and Decision Sciences Department (CIDES), Faculty of Medicine of the University of Porto, Rua Doutor Plácido da Costa, 4200-450, Porto, Portugal.
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He Y, Johnson C. Improving the redistribution of the security lessons in healthcare: An evaluation of the Generic Security Template. Int J Med Inform 2015; 84:941-9. [PMID: 26363788 DOI: 10.1016/j.ijmedinf.2015.08.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 08/18/2015] [Accepted: 08/19/2015] [Indexed: 11/29/2022]
Abstract
CONTEXT The recurrence of past security breaches in healthcare showed that lessons had not been effectively learned across different healthcare organisations. Recent studies have identified the need to improve learning from incidents and to share security knowledge to prevent future attacks. Generic Security Templates (GSTs) have been proposed to facilitate this knowledge transfer. The objective of this paper is to evaluate whether potential users in healthcare organisations can exploit the GST technique to share lessons learned from security incidents. METHODOLOGY We conducted a series of case studies to evaluate GSTs. In particular, we used a GST for a security incident in the US Veterans' Affairs Administration to explore whether security lessons could be applied in a very different Chinese healthcare organisation. RESULTS The results showed that Chinese security professional accepted the use of GSTs and that cyber security lessons could be transferred to a Chinese healthcare organisation using this approach. The users also identified the weaknesses and strengths of GSTs, providing suggestions for future improvements. CONCLUSION Generic Security Templates can be used to redistribute lessons learned from security incidents. Sharing cyber security lessons helps organisations consider their own practices and assess whether applicable security standards address concerns raised in previous breaches in other countries. The experience gained from this study provides the basis for future work in conducting similar studies in other healthcare organisations.
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Affiliation(s)
- Ying He
- School of Computer Science and Informatics, De Montfort University, UK.
| | - Chris Johnson
- School of Computing Science, University of Glasgow, UK
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Roueché A, Runnacles J. Improving care for the deteriorating child. Arch Dis Child Educ Pract Ed 2014; 99:61-6. [PMID: 24219877 DOI: 10.1136/archdischild-2013-304326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alice Roueché
- Department of Paediatrics, Royal Alexandra Children's Hospital, , Brighton, UK
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Patient Safety in Pediatrics. PATIENT SAFETY 2014. [DOI: 10.1007/978-1-4614-7419-7_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Daniels JP, Hunc K, Cochrane DD, Carr R, Shaw NT, Taylor A, Heathcote S, Brant R, Lim J, Ansermino JM. Identification by families of pediatric adverse events and near misses overlooked by health care providers. CMAJ 2011; 184:29-34. [PMID: 22105750 DOI: 10.1503/cmaj.110393] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Identifying adverse events and near misses is essential to improving safety in the health care system. Patients are capable of reliably identifying and reporting adverse events. The effect of a patient safety reporting system used by families of pediatric inpatients on reporting of adverse events by health care providers has not previously been investigated. METHODS Between Nov. 1, 2008, and Nov. 30, 2009, families of children discharged from a single ward of British Columbia's Children's Hospital were asked to respond to a questionnaire about adverse events and near misses during the hospital stay. Rates of reporting by health care providers for this period were compared with rates for the previous year. Family reports for specific incidents were matched with reports by health care providers to determine overlap. RESULTS A total of 544 familes responded to the questionnaire. The estimated absolute increase in reports by health care providers per 100 admissions was 0.5% (95% confidence interval -1.8% to 2.7%). A total of 321 events were identified in 201 of the 544 family reports. Of these, 153 (48%) were determined to represent legitimate patient safety concerns. Only 8 (2.5%) of the adverse events reported by families were also reported by health care providers. INTERPRETATION The introduction of a family-based system for reporting adverse events involving pediatric inpatients, administered at the time of discharge, did not change rates of reporting of adverse events and near misses by health care providers. Most reports submitted by families were not duplicated in the reporting system for health care providers, which suggests that families and staff members view safety-related events differently. However, almost half of the family reports represented legitimate patient safety concerns. Families appeared capable of providing valuable information for improving the safety of pediatric inpatients.
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Affiliation(s)
- Jeremy P Daniels
- Department of Anesthesiology, Pharmacology, and Therapeutics, The University of British Columbia, Vancouver, BC.
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Abstract
Patient Safety Reporting Systems are a commonly used method for capturing information about adverse events and near misses in the acute care setting. These event reports are almost exclusively submitted by the frontline care provider, and the patient perspective of the event is rarely captured. The authors present a case which illustrates the use of eliciting the patient's perspective to provide a complementary perspective to the provider's description of the event. The methodology for obtaining and using this information to enhance understanding of the event and to inform prevention strategies is described.
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