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Intelligent checklists improve checklist compliance in the intensive care unit: a prospective before-and-after mixed-method study.
De Bie, Ashley J R; Mestrom, Eveline; Compagner, Wilma; Nan, Shan; van Genugten, Lenneke; Dellimore, Kiran; Eerden, Jacco; van Leeuwen, Steffen; van de Pol, Harald; Schuling, Franklin; Lu, Xudong; Bindels, Alexander J G H; Bouwman, Arthur R A; Korsten, Erik H H M.
Afiliação
  • De Bie AJR; Department of Internal Medicine, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Intensive Care Unit, Catharina Hospital Eindhoven, Eindhoven, The Netherlands. Elec
  • Mestrom E; Department of Internal Medicine, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Intensive Care Unit, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
  • Compagner W; Healthcare Intelligence, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
  • Nan S; Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands; College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangz
  • van Genugten L; Department of Brain, Behaviour and Cognition, Philips Research, Eindhoven, The Netherlands.
  • Dellimore K; Department of Patient Care and Measurements, Philips Research, Eindhoven, The Netherlands.
  • Eerden J; Department of Philips Design, Eindhoven, The Netherlands.
  • van Leeuwen S; Department of Philips CTO, Eindhoven, The Netherlands.
  • van de Pol H; Healthcare Intelligence, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
  • Schuling F; Department of Philips CTO, Eindhoven, The Netherlands.
  • Lu X; College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hangzhou, China.
  • Bindels AJGH; Department of Intensive Care Unit, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
  • Bouwman ARA; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Anaesthesiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
  • Korsten EHHM; Department of Intensive Care Unit, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Healthcare Intelligence, Catharina Hospital Eindhoven, Eindhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
Br J Anaesth ; 126(2): 404-414, 2021 02.
Article em En | MEDLINE | ID: mdl-33213832
ABSTRACT

BACKGROUND:

We examined whether a context and process-sensitive 'intelligent' checklist increases compliance with best practice compared with a paper checklist during intensive care ward rounds.

METHODS:

We conducted a single-centre prospective before-and-after mixed-method trial in a 35 bed medical and surgical ICU. Daily ICU ward rounds were observed during two periods of 8 weeks. We compared paper checklists (control) with a dynamic (digital) clinical checklist (DCC, intervention). The primary outcome was compliance with best clinical practice, measured as the percentages of checked items and unchecked critical items. Secondary outcomes included ICU stay and the usability of digital checklists. Data are presented as median (interquartile range).

RESULTS:

Clinical characteristics and severity of critical illness were similar during both control and intervention periods of study. A total of 36 clinicians visited 197 patients during 352 ward rounds using the paper checklist, compared with 211 patients during 366 ward rounds using the DCC. Per ICU round, a median of 100% of items (94.4-100.0) were completed by DCC, compared with 75.1% (66.7-86.4) by paper checklist (P=0.03). No critical items remained unchecked by the DCC, compared with 15.4% (8.3-27.3) by the paper checklist (P=0.01). The DCC was associated with reduced ICU stay (1 day [1-3]), compared with the paper checklist (2 days [1-4]; P=0.05). Usability of the DCC was judged by clinicians to require further improvement.

CONCLUSIONS:

A digital checklist improved compliance with best clinical practice, compared with a paper checklist, during ward rounds on a mixed ICU. CLINICAL TRIAL REGISTRATION NCT03599856.
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Texto completo: 1 Coleções: 01-internacional Temas: Promover_ampliacao_atencao_especializada Base de dados: MEDLINE Assunto principal: Papel / Padrões de Prática Médica / Inteligência Artificial / Sistemas de Apoio a Decisões Clínicas / Cuidados Críticos / Visitas de Preceptoria / Lista de Checagem / Unidades de Terapia Intensiva Tipo de estudo: Clinical_trials / Guideline / Observational_studies / Prognostic_studies Aspecto: Patient_preference Limite: Humans Idioma: En Revista: Br J Anaesth Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Temas: Promover_ampliacao_atencao_especializada Base de dados: MEDLINE Assunto principal: Papel / Padrões de Prática Médica / Inteligência Artificial / Sistemas de Apoio a Decisões Clínicas / Cuidados Críticos / Visitas de Preceptoria / Lista de Checagem / Unidades de Terapia Intensiva Tipo de estudo: Clinical_trials / Guideline / Observational_studies / Prognostic_studies Aspecto: Patient_preference Limite: Humans Idioma: En Revista: Br J Anaesth Ano de publicação: 2021 Tipo de documento: Article