Design and implementation of a platform for configuring clinical dynamic safety checklist applications

Shan NAN; Xu-dong LU; Pieter VAN GORP; Hendrikus H. M. KORSTEN; Richard VDOVJAK; Uzay KAYMAK; Hui-long DUAN

doi:10.1631/FITEE.1700623

Your Location：

Home >

Browse articles >

Design and implementation of a platform for configuring clinical dynamic safety checklist applications

Regular Papers | Updated：2022-05-19

- Design and implementation of a platform for configuring clinical dynamic safety checklist applications
- 一种临床动态安全清单系统配置平台的设计与实现
- Frontiers of Information Technology & Electronic Engineering Vol. 19, Issue 7, Pages: 937-946(2018)
- Affiliations：
  
  Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China
  School of Industrial Engineering, Eindhoven University of Technology, Eindhoven 5600 MB, the Netherlands
  Department of Aneasthiaology and Intensive-Care, Catharina Ziekenhuis, Eindhoven 5623 EJ, the Netherlands
  Philips Research Eindhoven, Eindhoven 5656 AE, the Netherlands
- Author bio：
  
  [ "Shan NAN, E-mail: nanshan@zju.edu.cn" ]
  Xu-dong LU, E-mail:lvxd@zju.edu.cn
- Funds：
- DOI：10.1631/FITEE.1700623
  CLC： C936
- Received：22 September 2017，
  
  Revised：2018-;7-12，
  
  Published：2018-07
- Accepted：
Scan QR Code
Shan NAN, Xu-dong LU, Pieter VAN GORP, et al. Design and implementation of a platform for configuring clinical dynamic safety checklist applications[J]. Frontiers of Information Technology & Electronic Engineering, 2018, 19(7): 937-946.
DOI：

Shan NAN, Xu-dong LU, Pieter VAN GORP, et al. Design and implementation of a platform for configuring clinical dynamic safety checklist applications[J]. Frontiers of Information Technology & Electronic Engineering, 2018, 19(7): 937-946. DOI： 10.1631/FITEE.1700623.

摘要

近年来的研究日益表明，清单可显著改善病人安全。为促使清单在临床实践中有效使用，医学界和信息学界都建议把清单部署成动态清单系统，实现与临床信息系统的集成，动态适配病人上下文信息。然而，由于系统与特定内容的紧密耦合，开发这样的系统非常困难。提出一种临床安全清单系统动态配置平台，整合平台内部基础设施构建动态安全清单系统，避免用户为每个应用重复开发安全清单系统。分析现有清单系统功能和实施中的经验教训，定义了该平台的设计指标。然后整合基于规则的临床决策支持技术和工作流管理技术，设计了一套技术方案。基于该技术方案，设计开发了一套动态清单配置平台，并基于多个临床案例对其不断完善。通过应用该平台，开发了针对9个典型医疗流程的242个动态清单。结果表明，使用本文提出的方法实现临床动态安全清单系统的配置，具有可行性和通用性。

Abstract

In recent years

it has been demonstrated that checklists can improve patient safety significantly. To facilitate the effective use of checklists in daily practice

both the medical community and the informatics community propose to implement checklists in dynamic checklist applications that can be integrated into the clinical workflow and that is specific to the patient context. However

it is difficult to develop such applications because they are tightly intertwined with the content of specific checklists. We propose a platform that enables access to dynamic checklist applications by configuring the infrastructures provided in the platform. Then

the applications can be developed without time-consuming programming work. We define a number of design criteria regarding point of care and clinical processes by analyzing the existing checklist applications and the lessons learned from implementations. Then

by applying rule-based clinical decision support and workflow management technologies

we design technical mechanisms to satisfy the design criteria. A dynamic checklist application platform is designed based on these mechanisms. Finally

we build a platform in various design cycle iterations

driven by multiple clinical cases. By applying the platform

we develop nine comprehensive dynamic checklist applications with 242 dynamic checklists. The results demonstrate both the feasibility and the overall generic nature of the proposed approach. We propose a novel platform for configuring dynamic checklist applications. This platform satisfies the general requirements and can be easily configured to satisfy different scenarios in which safety checklists are used.

关键词

Keywords

references

R Amarasingham , , , PJ Pronovost , , , M Diener-West , , , 等 . . Measuring clinical information technology in the ICU setting: application in a quality improvement collaborative . . J Am Med Inform Assoc , , 2007 . . 14 ( ( 3 ): ): 288 - - 294 . . DOI: 10.1197/jamia.M2262 http://doi.org/10.1197/jamia.M2262 . .

E Anthes . . Hospital checklists are meant to save lives— so why do they often fail . . Nature , , 2015 . . 523 ( ( 7562 ): ): 516 - - 518 . . DOI: 10.1038/523516a http://doi.org/10.1038/523516a . .

AF Arriaga , , , AM Bader , , , JM Wong , , , 等 . . Simulationbased trial of surgical-crisis checklists . . N Engl J Med , , 2013 . . 368 ( ( 3 ): ): 246 - - 253 . . DOI: 10.1056/NEJMsa1204720 http://doi.org/10.1056/NEJMsa1204720 . .

GS Avrunin , , , LA Clarke , , , LJ Osterweil , , , 等 . . Smart checklists for human-intensive medical systems . . IEEE/IFIP Int Conf on Dependable Systems and Networks Workshops , , 2012 . . p.1 - - 6 . . DOI: 10.1109/DSNW.2012.6264661 http://doi.org/10.1109/DSNW.2012.6264661 . .

GR Baker , , , PG Norton , , , V Flintoft , , , 等 . . The Canadian adverse events study: the incidence of adverse events among hospital patients in Canada . . CMAJ , , 2004 . . 170 ( ( 11 ): ): 1678 - - 1686 . . DOI: 10.1503/cmaj.1040498 http://doi.org/10.1503/cmaj.1040498 . .

A Borchard , , , DLB Schwappach , , , A Barbir , , , 等 . . A systematic review of the effectiveness, compliance, and critical factors for implementation of safety checklists in surgery . . Ann Surg , , 2012 . . 256 ( ( 6 ): ): 925 - - 933 . . DOI: 10.1097/SLA.0b013e3182682f27 http://doi.org/10.1097/SLA.0b013e3182682f27 . .

AJR de Bie , , , S Nan , , , LRE Vermeulen , , , 等 . . Intelligent dynamic clinical checklists improved checklist compliance in the intensive care unit . . Br J Anaesth , , 2017 . . 119 ( ( 2 ): ): 231 - - 238 . . DOI: 10.1093/bja/aex129 http://doi.org/10.1093/bja/aex129 . .

EN de Vries , , , MW Hollmann , , , SM Smorenburg , , , 等 . . Development and validation of the SURgical PAtient Safety System (SURPASS) checklist . . Qual Saf Health Care , , 2009 . . 18 ( ( 2 ): ): 121 - - 126 . . DOI: 10.1136/qshc.2008.027524 http://doi.org/10.1136/qshc.2008.027524 . .

EN de Vries , , , HA Prins , , , RMPH Crolla , , , 等 . . Effect of a comprehensive surgical safety system on patient outcomes . . N Engl J Med , , 2010 . . 363 ( ( 20 ): ): 1928 - - 1937 . . DOI: 10.1056/NEJMsa0911535 http://doi.org/10.1056/NEJMsa0911535 . .

A Fourcade , , , JL Blache , , , C Grenier , , , 等 . . Barriers to staff adoption of a surgical safety checklist . . BMJ Qual Saf , , 2012 . . 21 ( ( 3 ): ): 191 - - 197 . . DOI: 10.1136/bmjqs-2011-000094 http://doi.org/10.1136/bmjqs-2011-000094 . .

T Garg , , , JY Lee , , , KH Evans , , , 等 . . Development and evaluation of an electronic health record-based bestpractice discharge checklist for hospital patients . . Jt Commiss J Qual Patient Saf , , 2015 . . 41 ( ( 3 ): ): 126 - - 131 . . DOI: 10.1016/S1553-7250(15)41017-7 http://doi.org/10.1016/S1553-7250(15)41017-7 . .

P Gooch , , , A Roudsari . . Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems . . J Am Med Inform Assoc , , 2011 . . 18 ( ( 6 ): ): 738 - - 748 . . DOI: 10.1136/amiajnl-2010-000033 http://doi.org/10.1136/amiajnl-2010-000033 . .

E Grigg . . Smarter clinical checklists: how to minimize checklist fatigue and maximize clinician performance . . Anesth Analg , , 2015 . . 121 ( ( 2 ): ): 570 - - 573 . . DOI: 10.1213/ANE.0000000000000352 http://doi.org/10.1213/ANE.0000000000000352 . .

LA Hassell , , , AV Parwani , , , L Weiss , , , 等 . . Challenges and opportunities in the adoption of College of American Pathologists checklists in electronic format: perspectives and experience of Reporting Pathology Protocols Project (RPP2) participant laboratories . . Arch Pathol Lab Med , , 2010 . . 134 ( ( 8 ): ): 1152 - - 1159 . . http://www.archivesofpathology.org/doi/10.1043/2009-0386-OA.1 http://www.archivesofpathology.org/doi/10.1043/2009-0386-OA.1 , , . .

AB Haynes , , , TG Weiser , , , WR Berry , , , 等 . . A surgical safety checklist to reduce morbidity and mortality in a global population . . N Engl J Med , , 2009 . . 360 ( ( 5 ): ): 491 - - 499 . . DOI: 10.1056/NEJMsa0810119 http://doi.org/10.1056/NEJMsa0810119 . .

O Idahosa , , , JM Kahn . . Beyond checklists: using clinician prompts to achieve meaningful ICU quality improvement . . Crit Care , , 2012 . . 16 ( ( 1 ): ): Article 305 DOI: 10.1186/cc11199 http://doi.org/10.1186/cc11199 . .

SS Liu , , , BM Togioka , , , RW Hurley , , , 等 . . Methodological quality of randomized controlled trials of postoperative epidural analgesia: validation of the epidural analgesia trial checklist as a specific instrument to evaluate methodology . . Reg Anesth Pain Med , , 2010 . . 35 ( ( 6 ): ): 549 - - 555 . . DOI: 10.1097/AAP.0b013e3181fa114e http://doi.org/10.1097/AAP.0b013e3181fa114e . .

S Malhotra , , , D Jordan , , , E Shortliffe , , , 等 . . Workflow modeling in critical care: piecing together your own puzzle . . J Biomed Inform , , 2007 . . 40 ( ( 2 ): ): 81 - - 92 . . DOI: 10.1016/j.jbi.2006.06.002 http://doi.org/10.1016/j.jbi.2006.06.002 . .

PC Mullan , , , CG Macias , , , D Hsu , , , 等 . . A novel briefing checklist at shift handoff in an emergency department improves situational awareness and safety event identification . . Pediatr Emerg Care , , 2014 . . 31 ( ( 4 ): ): 231 - - 238 . . DOI: 10.1097/PEC.0000000000000194 http://doi.org/10.1097/PEC.0000000000000194 . .

S Nan , , , P van Gorp , , , HHM Korsten , , , 等 . . Tracebook: a dynamic checklist support system . . IEEE 27 th Int Symp on Computer-Based Medical Systems , , 2014 . . p.48 - - 51 . . DOI: 10.1109/CBMS.2014.33 http://doi.org/10.1109/CBMS.2014.33 . .

S Nan , , , X Lu , , , Z Yang , , , 等 . . An intelligent support system for patient safety checklists . . Chin J Biomed Eng , , 2017 . . 36 ( ( 3 ): ): 329 - - 335 . . DOI: 10.3969/j.issn.0258-8021.2017.03.010 http://doi.org/10.3969/j.issn.0258-8021.2017.03.010 . .

NM Pageler , , , CA Longhurst , , , M Wood , , , 等 . . Use of electronic medical record-enhanced checklist and electronic dashboard to decrease CLABSIs . . Pediatrics , , 2014 . . 133 ( ( 3 ): ): 738 - - 746 . . DOI: 10.1542/peds.2013-2249 http://doi.org/10.1542/peds.2013-2249 . .

M Peleg . . Computer-interpretable clinical guidelines: a methodological review . . J Biomed Inform , , 2013 . . 46 ( ( 4 ): ): 744 - - 763 . . DOI: 10.1016/j.jbi.2013.06.009 http://doi.org/10.1016/j.jbi.2013.06.009 . .

SJ Russ , , , N Sevdalis , , , K Moorthy , , , 等 . . A qualitative evaluation of the barriers and facilitators toward implementation of the WHO surgical safety checklist across hospitals in England: lessons from the "Surgical Checklist Implementation Project" . . Ann Surg , , 2015 . . 261 ( ( 1 ): ): 81 - - 91 . . DOI: 10.1097/SLA.0000000000000793 http://doi.org/10.1097/SLA.0000000000000793 . .

C Rydenfält , , , Å Ek , , , PA Larsson . . Safety checklist compliance and a false sense of safety: new directions for research . . BMJ Qual Saf , , 2014 . . 23 ( ( 3 ): ): 183 - - 186 . . DOI: 10.1136/bmjqs-2013-002168 http://doi.org/10.1136/bmjqs-2013-002168 . .

J Shillito , , , K Arfanis , , , A Smith . . Checking in healthcare safety: theoretical basis and practical application . . Int J Health Care Qual Assur , , 2010 . . 23 ( ( 8 ): ): 699 - - 707 . . DOI: 10.1108/09526861011081831 http://doi.org/10.1108/09526861011081831 . .

C Thongprayoon , , , AM Harrison , , , JC O'Horo , , , 等 . . The effect of an electronic checklist on critical care provider workload, errors, and performance . . J Intens Care Med , , 2014 . . 31 ( ( 3 ): ): 205 - - 212 . . DOI: 10.1177/0885066614558015 http://doi.org/10.1177/0885066614558015 . .

TG Weiser , , , AB Haynes , , , A Lashoher , , , 等 . . Perspectives in quality: designing the WHO surgical safety checklist . . Int J Qual Health Care , , 2010 . . 22 ( ( 5 ): ): 365 - - 370 . . DOI: 10.1093/intqhc/mzq039 http://doi.org/10.1093/intqhc/mzq039 . .

RP Wenzel , , , MB Edmond . . Team-based prevention of catheter-related infections . . N Engl J Med , , 2006 . . 355 ( ( 26 ): ): 2781 - - 2783 . . DOI: 10.1056/NEJMe068230 http://doi.org/10.1056/NEJMe068230 . .

JE Ziewacz , , , AF Arriaga , , , AM Bader , , , 等 . . Crisis checklists for the operating room: development and pilot testing . . J Am Coll Surg , , 2011 . . 213 ( ( 2 ): ): 212 - - 217.e10 . . DOI: 10.1016/j.jamcollsurg.2011.04.031 http://doi.org/10.1016/j.jamcollsurg.2011.04.031 . .

Views

Downloads

CSCD

Alert me when the article has been cited

Submit

Tools

Publicity Resources

No data

Related Author

No data

Related Institution

No data

Chat

Address：Zhejiang University Press, 148 Tianmushan Road, Hangzhou, China Postal code：310028
Tel：+86-571-88273162 Email：fitee@zju.edu.cn
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰