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Institute for the Design of Environments Aligned for Patient Safety (IDEA4PS)

Principal Investigators: Ann Scheck McAlearney, Sc.D., M.S., The Ohio State University, Columbus, OH; formerly Susan Moffatt-Bruce, M.D., Royal College of Physicians and Surgeons of Canada, Ottawa
AHRQ Grant No.: HS024379
Project Period: 09/30/15-09/29/20
Description: The goal of the Institute for the Design of Environments Aligned for Patient Safety (IDEA4PS) was to improve workflows and information transfers in the healthcare environment.

The specific aims were to:

  • Explore how cardiac alarms affect healthcare provider decision making.
  • Conduct surveillance of healthcare-acquired infections in real time.
  • Implement and evaluate secure messaging in electronic health records (EHRs).

The development of the IDEA4PS Lab provided foundational infrastructure to connect stakeholders across Ohio State University and Wexner Medical Center to conduct rigorous research in the context of practice. This focus allowed research to inform operations in a cycle of continuous improvement where clinicians and researchers, including health services experts, analysts, and information technology staff, worked together and improved clinical practice by designing, testing, and exploring the types of information flows resulting in a safer healthcare work environment.

IDEA4PS's work reduced the alarm burden of bedside monitors and the Secondary Alarm Notification System (SANS) that is delivered on nurses' phones. These improvements allowed clinicians to focus on meaningful events over the din of background noise, leading to enhanced safety and quality of patient care. This goal was achieved by[1-7]:

  • Changing policies at five hospitals to reduce false alarms.
  • Redesigning audio tones for telemetry alarms.
  • Identifying needs of patients and families to improve satisfaction with alarms.
  • Assisting in making changes to tones for a new mobile phone platform with SANS and including a new hospital.

The IDEA4PS Lab automated surveillance of hospital-acquired infections to provide results in near real time to stakeholders and tested different visualizations for surveillance results by[8-10]:

  • Creating a simple Clostridium difficile (C. diff) algorithm that correctly identifies all hospital-onset C. diff infections.
  • Developing a demonstration C. diff interactive dashboard that uses a map of the hospital as a form of visualization and building data infrastructure that assesses space and time by leveraging geographic information systems to better track infections within the hospital. This dashboard can be applied to other quality and safety outcomes that may benefit from localization within the hospital.

Finally, IDEA4PS explored how hospitalwide use of MyChart Bedside (MCB), an inpatient patient portal, affected the provider work system and processes. After interviews with hospital staff, a health system-level committee was convened to translate findings into operational improvements. These changes included hiring technology navigators to assist with MCB provisioning and training both patients and clinicians on MCB use.[11-14]

This PSLL’s work has resulted in at least 70 peer-reviewed journal publications, with nearly 600 citations in other publications; nearly 90 presentations at institutions and conferences; and creation of a website ().

Publications

2021

  • MacEwan SR, et al. . Patient Educ Couns. 2021 Apr;104(4):836-43.

2020

  • DePuccio MJ, et al. . J Gen Intern Med. 2020;35(10):3122-5.
  • Di Tosto G, et al. . J Med Internet Res. 2020 Jun 12;22(6):e16849. 
  • Furniss S, et al. . Perspect Health Inf Manag 2020 Winter.
  • Hefner JL, et al. . Health Care Manage Rev. 2020 May 5. Online ahead of print.
  • McAlearney AS, et al. . Med Care Res Rev. 2020 Jun 17:1077558720925296.
  • McAlearney AS, et al. . Telemed J E Health. 2020;26(9):1184-7.
  • McAlearney AS, et al. . Telemed J E Health. 2020;26(3):310-26.
  • McHaney-Lindstrom M, et al. . Health Info Libr J. 2020;37(1):26-34.
  • Patterson ES, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2020;9(1):61-5.
  • Patterson ES, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2020 Sept;9(1):10-4. 
  • Valvona SN, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2020;9(1):105-9. 
  • Walker DM, et al. . Telemed J E Health. 2020 May;26(5):603-13.

2019

  • Carter R, et al. . Proc Hum Factors Ergon Soc Annu Meet. 2019 Nov 20;63(1).
  • Fareed N, et al. . J Am Med Inform Assoc. 2019;26(1):28-36.
  • Hebert C, Root ED. . Adv Health Care Manag. 2019 Oct 24;18. 
  • Horwood CR, et al. . Adv Health Care Manage. 2019 Oct 24;18:159-71. 
  • Huerta T, et al. . J Med Internet Res. 2019;21(3):e10957.
  • McAlearney AS, et al. . Appl Clin Inform. 2019;10(1):103-112.
  • McAlearney AS, et al. . J Med Internet Res. 2019;21(6):e13126.
  • McGrath SP, et al. . IEEE J Biomed Health Inform. 2019;23(2):857-66.
  • Melsop S, et al. . Int J Design Manage Prof Pract. 2019;13(3):1-12. 
  • Moffatt-Bruce SD, et al. Am J Med Qual. 2019;34(5):502-8.
  • Mount-Campbell AF, et al. . J Cogn Eng Decis Mak. 2019;13(2):67-80.
  • Patterson ES, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2019 Sept;8(1):4-8. 
  • Patterson ES, et al. Proc Int Symp Hum Factors Ergon Healthc. 2019 Sept;8(1):115-9. 
  • Rayo MF, et al. . Ergonomics. 2019;62(12):1617-29.
  • Reynolds M, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2019;8:142-5.
  • Sieck CJ, et al. The patient engagement capacity model: what factors determine a patient’s ability to engage? NEJM Catalyst. 2019 Mar 13. https://www.canaryhealth.com/wp-content/uploads/2019/05/Patient-Engagement-Capacity-Model_-Determining-Patient-Ability-to-Engage-NEJM-catalyst-2019.pdf.
  • Vink S, et al. . Perspect Health Inf Manage. 2019 Fall;16(Fall):1i. eCollection 2019 Fall.
  • Walker DM, et al. . Appl Clin Inform. 2019 Oct;10(5):898-908. 
  • Yu SC, et al. . ACI open. 2019 Jul;3(2):e71-e77.

2018

  • Duchemin AM, et al. Utilizing mindfulness with health-care professionals to improve burnout, self-compassion, and patient quality and safety measures: a comparison of cardiac units. Glob Adv Health Med. 2018;7:139-40. doi: 10.1177/2164956118773837.
  • Edworthy J, et al. . Ergon Des. 2018;26(4):4-13. 
  • Hefner JL, et al. . Appl Clin Inform. 2018;9(3):558-64.
  • Horwood CR, et al. . Surgery. 2018;164(6):1311-5.
  • Horwood CR, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2018;7(1):112-6.
  • Knupp AM, et al. . J Nurs Adm. 2018;48(12):642-8.
  • Moffatt-Bruce S, et al. . Am J Med Qual. 2018;33(4):420-5.
  • Patterson ES. . Hum Factors. 2018;60(3):281-92.
  • Patterson ES, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2018;7(1):224-31.
  • Patterson ES, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2018;7(1):123-8.
  • Rayo MF, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2018;7(1):1-7.
  • Sarkhel R, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2018;7(1):205-9.
  • Schmidt CR, et al. . J Surg Oncol. 2018;117(6):1113-8.
  • Sheffer J, et al. . Biomed Instrum Technol. 2018 Nov/Dec;52(6):454-61. 
  • Sieck CJ, et al. . Patient Exp J. 2018;5(3):Article 8.
  • Sieck CJ, et al. . Appl Clin Inform. 2018;9(4):860-8.
  • Walker DM, et al. . J Med Syst. 2018;42(9):158.
  • Walker DM, et al. . Appl Clin Inform. 2018;9(1):105-13.
  • Yen PY, et al. . Int J Med Inform. 2018;110:10-8.

2017

  • Hefner JL, et al. Am J Med Qual. 2017;32(4):384-90.
  • Hefner JL, et al. . J Am Med Inform Assoc. 2017;24(2):310-5.
  • Hefner JL, et al. . JMIR Med Inform. 2017;5(3):e31.
  • Moffatt-Bruce SD, et al. . J Surg Oncol. 2017;116(5):601-7.
  • Patterson ES, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2017;6(1):125-31.
  • Patterson ES, et al. . Jt Comm J Qual Patient Saf. 2017;43(8):375-85.
  • Sieck CJ, et al. . JMIR Med Inform. 2017;5(3):e13.
  • Walker DM, et al. J Am Med Inform Assoc. 2017;24(6):1088-94.
  • Yen PY, et al. . JMIR Med Inform. 2017;5(3):e28.

2016

  • Carballo NJ, et al. . Clin Ther. 2016;38(11):2407-15.
  • Elsharydah A, et al. . Ann Med Surg (Lond). 2016;12:60-4.
  • Fairbanks RJ. . Proc Hum Factors Ergon Soc Annu Meet. 2016 Sep;60(1):643-6.
  • Ford EW, et al. . Int J Health Care Qual Assur. 2016;29(6):614-27.
  • Moffatt-Bruce S, Huerta T. . Int J Acad Med. 2016;2(3):2-5.
  • Nguyen MC, et al. . J Am Coll Surg. 2016;223(4):e168.
  • Rayo MF, et al. . BMJ Qual Saf. 2016;25(10):796-802.
  • Rayo MF, Moffatt-Bruce SD. . Jt Comm J Qual Patient Saf. 2016 Jul;42(7):291-2.
  • Reale C, et al. . Proc Hum Factors Ergon Soc Annu Meet. 2016;60:647-51.

References

  1. Rayo MF, et al. . BMJ Qual Saf. 2016;25(10):796-802.
  2. Rayo MF, Moffatt-Bruce SD. . Jt Comm J Qual Patient Saf. 2016 Jul;42(7):291-2.
  3. Rayo MF, et al. . Ergonomics. 2019;62(12):1617-29.
  4. Sarkhel R, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2018;7(1):205-9.
  5. Edworthy J, et al. . Undated online manuscript.
  6. Nguyen MC, et al. . J Am Coll Surg. 2016;223(4):e168.
  7. Reynolds M, et al. . Proc Int Symp Hum Factors Ergon Healthc. 2019;8:142-5.
  8. McHaney-Lindstrom M, et al. . Health Info Libr J. 2020;37(1):26-34.
  9. Yu SC, et al. . ACI open. 2019 Jul;3(2):e71-e77.
  10. McAlearney AS, et al. . Implement Sci. 2017;12(1):82.
  11. McAlearney AS, et al. . Telemed J E Health. 2020;26(3):310-26.
  12. McAlearney, AS, et al. . Med Care Res Rev. 2020:1077558720925296.
  13. Walker DM, et al. . Telemed J E Health. 2020 May;26(5):603-13.
  14. MacEwan SR, et al. . Patient Educ Couns. 2021 Apr;104(4):836-43.
Page last reviewed April 2021
Page originally created April 2021

Internet Citation: Institute for the Design of Environments Aligned for Patient Safety (IDEA4PS). Content last reviewed April 2021. Agency for Healthcare Research and Quality, Rockville, MD.
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