The Brigham and Women’s Hospital (BWH) Patient Safety Learning Laboratory (PSLL), led by Principal Investigator David W. Bates, MD, MSc, is an exciting new collaboration between the Center for Patient Safety Research and Practicend Northeastern University’s Healthcare Systems Engineering Institute (HSyE), led by Co-Principal Investigator James C. Benneyan, PhD. The PSLL will achieve its vision of making acute care more patient-centered by developing systems approaches to integrating health information technology (HIT), stakeholder engagement mechanisms, process design and engineering methods. The PSLL is funded and run by a grant from the Agency for Health Care Research and Quality (AHRQ).
The PSLL will conduct three core projects over a four-year period, focusing on patient safety, development and enhancement of tools, health care system interventions, and translation into practice. The three core projects of the PSLL are:1) Patient-centered Fall Prevention Toolkit, led by BWH Co-Investigator Patricia Dykes RN, PhD, which aims to engage patients and their family caregivers in the design of HIT tools to prevent patient falls and related injuries during an acute hospitalization; 2) Design and development of a Patient Safety Checklist Tool, led by BWH Co-Investigators Lisa Lehmann, MD, PhD and Kumiko Schnock, RN, PhD, to improve patient safety and quality outcomes, provider efficiency, and team communication ; and 3) MySafeCare Patient Safety Reporting System, led by BWH Co-Investigator Sarah Collins, RN, PhD, which aims to iteratively develop and evaluate the impact of a patient safety reporting system on patient safety and fosters a health system focused on collaborative learning.
A Patient Safety Dashboard will integrate information from all three projects of the PSLL to facilitate awareness of the status of patient safety metrics between members of the health care team and patients and family members. An Administrative Core will provide administrative oversight through methodological, translation and dissemination expertise. A Systems Engineering, Usability, and Integration Core,led by BWH Co-Investigator Anuj Dalal, MD, will leverage health systems engineering approaches to develop the three projects at the individual level. In addition, a model, known as the Patient SatisfActive® will be developed, tested, and refined by David W. Bates MD MSc and Ronen Rozenblum, PhD to create a culture of patient- and family-centered care and provide a system-wide methodology to aid in the successful implementation and improvement of HIT tools on BWH patient care units
The PSLL has just completed a year of significant progress on three projects, developing tools to foster a health system focused on collaborative learning. During phase one, problem analysis, the three projects conducted workflow observations, surveys and focus groups with clinicians, patients and family members to identify software and workflow requirements, which aided in discovery of participants’ experiences and perspectives and enabled the PSLL to complete phase two, designing iterative prototypes for the PSLL toolkits. Currently, we are finalizing phase three, developing and refining the three toolkits in preparation for a proof of concept pilot in October 2015. The Fall Prevention project plans to pilot paper and electronic fall prevention tools on four Oncology Units and four Medicine Units, as well as mobile and iPad Fall Prevention tools and a clinician desktop screensaver on two Oncology Units. The Safety Checklist Tool project will pilot an electronic checklist for daily rounds on the Medical Intensive Care Unit (MICU), and a patient and unit-level aggregate dashboard. The MySafeCare pilot has been active since May on MICU and Oncology, and will be deploying robust clinical dashboard features. The three projects are aligning to deliver an integrated patient safety portal and screensaver. Phase four will involve evaluation and refinement of the toolkits. Future phases will focus on broader implementation and scalability, and the PSLL aims to implement the toolkits as part of a main trial in April 2016.
The BWH PSLL will establish a vibrant learning ecosystem of health services, informatics, and systems engineering researchers, collaborating with patients and family to evolve and apply these approaches to adverse event prevention in hospitalized patients. The HSyE program will contribute within the PSLL via its many developed engineering methods and tools, including statistical methods for “bundling” checklist compliance, rare and risk-adjusted adverse events, and statistical control charts based on interrupted time series concepts. Through increased implementation and use of HIT and patient/family engagement in their plan of care, this PSLL, its cores, and its projects will provide information, strategies, and tools for utilizing HIT to facilitate patient activation in eliminating harm in hospital settings.
This project is supported by grant number P30HS023535 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. | © 2015