An Implementation Science Approach to Promote Optimal Implementation, Adoption, Use, and Spread of Continuous Clinical Monitoring System Technology
| Autor: | Graham Lowenthal, Patricia C. Dykes, Deborah Harding, Ann C. Hurley, Carolyn Huffman Whnp, Michelle Waters Leonard, Robin Hack, Perry G. An, Ann Faris |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Process management Leadership and Management Computer science 030503 health policy & services Communication Public Health Environmental and Occupational Health MEDLINE Qualitative property Workload Monitoring system Troubleshooting Middle Aged Telemedicine 03 medical and health sciences 0302 clinical medicine Workflow Software deployment Clinical staff Humans Female 030212 general & internal medicine 0305 other medical science Implementation Science |
| Zdroj: | Journal of patient safety. 17(1) |
| ISSN: | 1549-8425 |
| Popis: | Objectives This study aimed to apply implementation science tenets to guide the deployment and use of in-hospital Clinical Monitoring System Technology (CMST) and to develop a toolkit to promote optimal implementation, adoption, use, and spread of CMST. Methods Six steps were carried out to (1) establish leadership support; (2) identify, educate, and sustain champions; (3) enlist clinical staff users to learn barriers and facilitators; (4) examine initial qualitative data from 11 clinician group interviews; (5) validate barriers/facilitators to CMST use and toolkit content; and (6) propose a toolkit to promote utilization. Clinical Monitoring System Technology output before and after implementation were compared. Results The top 3 barriers to effective CMST use were as follows: (1) inadequate education/training/support, (2) clinical workflow challenges, and (3) lack of communication. Facilitators to CMST implementation and adoption included the following: (1) providing comprehensive and consistent CMST education, (2) presenting evidence early and often, (3) tailoring device and usage expectations to individual environments, and (4) providing regular feedback about progress. Empirical data drove the development of a CMST implementation toolkit covering 6 areas: (1) why, (2) readiness, (3) readiness and implementation, (4) patient/family introduction, (5) champions, (6) care team saves, and (7) troubleshooting. Clinical Monitoring System Technology positively impacted failure to rescue events. Monthly median cardiac alert responses decreased from 30 to 3.64 minutes (87.9%), and respiratory alert responses decreased from 26 to 4.85 minutes (81.4%). Conclusions Using implementation science tenets to concurrently guide deployment and study performance of 2 CMST devices and impact on workload was effective for both learning CMST efficacy at 2 hospital systems and developing a toolkit to promote optimal implementation, adoption, use, and spread. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|