Development and Evaluation of Patient Safety Interventions: Perspectives of Operational Safety Leaders and Patient Safety Organizations.

OBJECTIVES: The purpose of this study is to understand how patient safety professionals from healthcare facilities and patient safety organizations develop patient safety interventions and the resources used to support intervention development. METHODS: Semistructured interviews were conducted with patient safety professionals at nine healthcare facilities and nine patient safety organizations. Interview data were qualitatively analyzed, and findings were organized by the following: patient safety solutions and interventions, use of external databases, and evaluation of patient safety solutions. RESULTS: Development of patient safety interventions across healthcare facilities and patient safety organizations was similar and included literature searches, internal brainstorming, and interviews. Nearly all patient safety professionals at healthcare facilities reported contacting colleagues at other healthcare facilities to learn about similar safety issues and potential interventions. Additionally, less than half of patient safety professionals at healthcare facilities and patient safety organizations interviewed report data to publicly available patient safety databases. Finally, most patient safety professionals at healthcare facilities and patient safety organizations stated that they evaluate the effectiveness of patient safety interventions; however, they mentioned methods that may be less rigorous including audits, self-reporting, and subjective judgment. CONCLUSIONS: Patient safety professionals often utilize similar methods and resources to develop and evaluate patient safety interventions; however, many of these efforts are not coordinated across healthcare organizations and could benefit from working collectively in a systematic fashion. Additionally, healthcare facilities and patient safety organizations face similar challenges and there are several opportunities for optimization on a national level that may improve patient safety.

Telemedicine and In-Person Visit Modality Mix and Electronic Health Record Use in Primary Care.

This cross-sectional study investigates the association between day-to-day changes in telemedicine share and clinician time spent on electronic health record (EHR) use.

Pilot assessment of an on-demand telehealth 'left without being seen' follow-up programme.

INTRODUCTION: On-demand telehealth can have a high rate of patients requesting visits and dropping off without being seen by a provider, especially during the COVID-19 pandemic. METHODS: On-demand telehealth requests made to a large healthcare system in the USA between 15 March 2020 and 31 May 2020 were included for analysis with a focus on patients who were defined as left without being seen (LWBS). As part of a pilot program a registered nurse attempted to call LWBS patients within 24 hours of their telehealth request and asked if they were ok, if they sought care for their original visit reason, what that care was, or if they still needed guidance. This information and patient demographics were analyzed. RESULTS: During the study period there were 21,610 completed on-demand telehealth visits and 1852 patients for whom there were LWBS attempted follow-ups. Most patients LWBS for a reason that originated from the patient and not associated with the provider or telehealth platform. The mean wait time for LWBS patients was 12.4 min compared to patients waiting 15.1 min before engaging with a provider to complete a visit. Of the 1852 total LWBS patients in the follow-up programme, 819 (44.2%) were successfully contacted with a follow-up phone call. Most of these patients (63.2%) already completed or planned to complete a telehealth visit, 13.6% indicated they no longer needed to see a provider, and 12.8% planned or already completed an in-person visit. Only 2.2% went to an emergency department. DISCUSSION: Results suggest patients can effectively self-manage their care needs.

Now You Feel It, Now You Don't: The Effect of Movement, Cue Complexity, and Body Location on Tactile Change Detection.

OBJECTIVE: To evaluate the effects that movement, cue complexity, and the location of tactile displays on the body have on tactile change detection. BACKGROUND: Tactile displays have been demonstrated as a means to address data overload by offloading the visual and auditory modalities. However, change blindness-the failure to detect changes in a stimulus when changes coincide with another event or disruption in stimulus continuity-has been demonstrated to affect the tactile modality and may be exacerbated during movement. The complexity of tactile cues and locations of tactile displays on the body may also affect the detection of changes in tactile patterns. Limitations to tactile perception need to be examined. METHOD: Twenty-four participants performed a tactile change detection task while sitting, standing, and walking. Tactile cues varied in complexity and included low, medium, and high complexity cues presented to the arm or back. RESULTS: Movement adversely affects tactile change detection as hit rates were the highest while sitting, followed by standing and walking. Cue complexity affected tactile change detection: Low complexity cues resulted in higher detection rates compared with medium and high complexity cues. The arms exhibited better change detection performance than the back. CONCLUSION: The design of tactile displays should consider the effect of movement. Cue complexity should be minimized and decisions about the location of a tactile display should take into account body movements to support tactile perception. APPLICATION: The findings can provide design guidelines to inform tactile display design for data-rich, complex domains.

The Evaluation of Tactile Parameters and Display Prototype to Support Physiological Monitoring and Multitasking for Anesthesia Providers in the Operating Room.

Communicating physiological information via the tactile modality is shown as a promising means to address data overload faced by anesthesia providers. However, it is important to ensure that the tactile parameters which represent information are intuitive. There is currently no consensus on which tactile parameters should be used to present information within anesthesia. The two studies presented here evaluate: (a) a set of 24 tactile cues manipulating intensity, temporal, and spatial tactile parameters in a usability study and (b) a prototype tactile display based on the usability study's findings in a single and dual-task scenario. Findings of the usability study show intensity and temporal were rated most urgent and had the most potential to represent changes in physiological measures. This was confirmed in the follow up study as increases/decreases in intensity were shown to represent increases/decreases in a physiological measure and using different spatial locations to represent physiological measures resulted in greater than 95% response accuracy. Response times and accuracy were not adversely affected while performing a secondary task. The findings contribute to a better understanding of how to map tactile parameters to physiological information and demonstrate the effectiveness of end-user feedback in tactile display design to develop intuitive alerts.