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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 64 Research Studies DisplayedSparling JL, France D, Abraham J
Handoff Effectiveness Research in periOperative environments (HERO) Design Studio: a conference report.
This conference report reviewed the historical background which led to the Handoff Effectiveness Research in periOperative environments (HERO) Design Studio. The objectives of the HERO Design Studio were to examine the existing literature base, create a national research agenda, and build the research infrastructure necessary to address critical evidence gaps in perioperative handoff quality and safety. The authors described how they prepared for the research conference and synthesized the conference’s results. They also recommended future directions regarding perioperative handoff improvement.
AHRQ-funded; HS027769.
Citation: Sparling JL, France D, Abraham J .
Handoff Effectiveness Research in periOperative environments (HERO) Design Studio: a conference report.
Jt Comm J Qual Patient Saf 2023 Aug; 49(8):422-30. doi: 10.1016/j.jcjq.2023.02.004..
Keywords: Health Information Technology (HIT), Workflow, Transitions of Care, Electronic Health Records (EHRs), Evidence-Based Practice
Sparling JL, Hong Mershon B, Abraham J
Perioperative handoff enhancement opportunities through technology and artificial intelligence: a narrative review.
This narrative review synthesized prior research on electronic tools for perioperative handoffs, limitations of current tools and barriers to their implementation, and use of AI and machine learning in perioperative care. Results showed that several efforts have incorporated electronic tools to improve perioperative handoffs, but were limited by imprecision in selecting handoff elements. AI and machine learning use and integration into handoff workflows were not yet being studied. Existing technology such as mobile applications, barcode scanners, and radio-frequency identification tags to advance perioperative safety were similarly not applied to handoffs.
AHRQ-funded; HS027769.
Citation: Sparling JL, Hong Mershon B, Abraham J .
Perioperative handoff enhancement opportunities through technology and artificial intelligence: a narrative review.
Jt Comm J Qual Patient Saf 2023 Aug; 49(8):410-21. doi: 10.1016/j.jcjq.2023.03.009..
Keywords: Health Information Technology (HIT), Workflow, Transitions of Care, Electronic Health Records (EHRs), Evidence-Based Practice
Zamudio J, Kanji FF, Lusk C
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
The goal of this observational study was to investigate the impact of robotic bariatric surgery (RBS) on the surgical work system via the study of flow disruptions (FDs), or deviations from the natural workflow progression. Twenty-nine RBS procedures were observed at three sites; FDs were recorded in real time and subsequently classified into one of nine work system categories. FDs occurred approximately every 2.4 minutes and happened most frequently during the final patient transfer and robot docking phases of RBS. The coordination challenges that contributed most to these disruptions were associated with waiting for staff/instruments and readjusting equipment.
AHRQ-funded; HS026491.
Citation: Zamudio J, Kanji FF, Lusk C .
Identifying workflow disruptions in robotic-assisted bariatric surgery: elucidating challenges experienced by surgical teams.
Obes Surg 2023 Jul; 33(7):2083-89. doi: 10.1007/s11695-023-06620-4..
Keywords: Obesity: Weight Management, Surgery, Workflow, Obesity
Huff NR, Chimowitz H, DelPico MA
The consequences of emotionally evocative patient behaviors on emergency nurses' patient assessments and handoffs: an experimental study using simulated patient cases.
The purpose of this experimental vignette research study was to explore the impact of emotionally evocative patient behavior and mental illness on 130 emergency nurses' emotions, patient assessments, testing advocacy, and written handoffs. The researchers asked the nurses to complete four multimedia computer-simulated patient encounters in which patient behavior (irritable vs. calm) and mental illness (present vs. absent) were purposely varied. The nurses recorded their emotions and clinical evaluations, recommended diagnostic tests, and provided written handoffs. The study found that the nurses experienced greater negative emotions (anger, unease) and reported decreased engagement when evaluating patients demonstrating irritable (vs. calm) behavior. Nurses also considered patients with irritable (vs. calm) behavior as more likely to exaggerate their pain and as poorer historians, and as less likely to cooperate, return to work, and recover. Nurses' handoffs were more likely to include negative descriptions of patients with irritable (vs. calm) behavior and exclude specific clinical information. The existence of mental illness increased unease and sadness and lead to nurses being less likely to recommend a needed test for a correct diagnosis.
AHRQ-funded; HS025752.
Citation: Huff NR, Chimowitz H, DelPico MA .
The consequences of emotionally evocative patient behaviors on emergency nurses' patient assessments and handoffs: an experimental study using simulated patient cases.
Int J Nurs Stud 2023 Jul; 143:104507. doi: 10.1016/j.ijnurstu.2023.104507..
Keywords: Emergency Department, Behavioral Health, Nursing, Workflow
Moy AJ, Hobensack M, Marshall K
Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments.
This study’s goal was to understand the perceived role of electronic health records (EHR) and workflow fragmentation on clinician documentation burden in the emergency department (ED). The authors conducted semistructured interviews with a national sample of US prescribing providers and registered nurses who actively practice in the adult ED setting and use Epic Systems' EHR. They recruited 12 prescribing providers and 12 registered nurses. Six themes were found related to EHR factors perceived to contribute to documentation burden including lack of advanced EHR capabilities, absence of EHR optimization for clinicians, poor user interface design, hindered communication, increased manual work, and added workflow blockages, and five themes associated with cognitive load. The relationship between workflow fragmentation and EHR documentation burden brought up two themes: underlying sources and adverse consequences.
AHRQ-funded; HS028454.
Citation: Moy AJ, Hobensack M, Marshall K .
Understanding the perceived role of electronic health records and workflow fragmentation on clinician documentation burden in emergency departments.
J Am Med Inform Assoc 2023 Apr 19; 30(5):797-808. doi: 10.1093/jamia/ocad038..
Keywords: Electronic Health Records (EHRs), Workflow, Health Information Technology (HIT), Emergency Department
Gephart SM, Tolentino DA, Quinn MC
Neonatal intensive care workflow analysis informing NEC-Zero clinical decision support design.
The aim of this qualitative descriptive study was to explore the current clinical workflow and sociotechnical processes of clinicians for necrotizing enterocolitis risk awareness, timely discovery of symptoms, and treatment to guide decision support design. The researchers conducted 11 focus groups in two neonatal ICUs. The study found that workflow processes were different for nurses (who observe the signs of necrotizing enterocolitis and inform providers to order diagnostic tests and treatments) and providers (who receive notification of necrotizing enterocolitis concern and then decide what actions to take). The researchers reported that clinicians wanted a necrotizing enterocolitis-relevant dashboard with: 1) nutrition tracking and recognition of necrotizing enterocolitis; 2) features to support decision-making; 3) breast milk tracking and feeding clinical decision support; 4) tools for necrotizing enterocolitis surveillance and quality reporting; and 5) general electronic health records improvements to enhance user experience.
AHRQ-funded; HS022908.
Citation: Gephart SM, Tolentino DA, Quinn MC .
Neonatal intensive care workflow analysis informing NEC-Zero clinical decision support design.
Comput Inform Nurs 2023 Feb; 41(2):94-101. doi: 10.1097/cin.0000000000000929..
Keywords: Newborns/Infants, Clinical Decision Support (CDS), Intensive Care Unit (ICU), Workflow, Health Information Technology (HIT)
Bourgoin A, Balaban R, Hochman M
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
The purpose of this study was to explain primary care-based transition workflow processes for hospitalized patients. The researchers conducted interviews with primary care thought leaders, staff at 9 primary care sites, community agency staff, and recently discharged patients. The researchers found that primary care postdischarge workflows vary across the different settings, rarely include communications with the patient or the inpatient team during the hospitalization and vary widely across settings. The researchers recommended the use of principles for primary care practices to encourage active participation in the full spectrum of postdischarge care, from admission through the first postdischarge visit to primary care.
AHRQ-authored; AHRQ-funded; 233201500019I/HHSP23337002T.
Citation: Bourgoin A, Balaban R, Hochman M .
Improving quality and safety for patients after hospital discharge: primary care as the lead integrator in postdischarge care transitions.
J Ambul Care Manage 2022 Oct-Dec;45(4):310-20. doi: 10.1097/jac.0000000000000433..
Keywords: Quality of Care, Patient Safety, Hospital Discharge, Transitions of Care, Hospitals, Workflow
Lobach DF, Boxwala A, Kashyap N
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
The authors sought to use interoperability standards to integrate the COVID-19 Tracker, a patient mobile application, with an EHR. Their clinical decision support integration project benefited from a standards-based approach, but they encountered challenges due to issues concerning implementation and experience of the standards-based application programming interface, Health Level 7 Fast Healthcare Interoperability Resources (FHIR) in the EHR. The authors concluded that FHIR standards may provide a promising mechanism for overcoming barriers in the integration of patient engagement apps with EHRs, but that expansion of available FHIR resources will improve workflow integration.
AHRQ-authored; AHRQ-funded; 233201500023I.
Citation: Lobach DF, Boxwala A, Kashyap N .
Integrating a patient engagement app into an electronic health record-enabled workflow using interoperability standards.
Appl Clin Inform 2022 Oct;13(5):1163-71. doi: 10.1055/s-0042-1758736..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Patient and Family Engagement, Workflow, COVID-19
Womack DM, Miech EJ, Fox NJ
Coincidence analysis: a novel approach to modeling nurses' workplace experience.
This study’s objective was to identify combinations of workplace conditions that uniquely differentiate high, medium, and low registered nurse (RN) ratings of appropriateness of patient assignment during daytime intensive care unit (ICU) work shifts. The RN members of the study team hypothesized a set of 55 workplace conditions having potential difference makers to define high, medium, and low perception of patient assignment appropriateness. An analysis of 64 cases (25 high, 24 medium, and 15 low) produced three models, one for each level of the outcome. The high appropriateness model was the simplest with two paths: 1) an absence of overtime and before-noon patient discharge or transfer; and 2) an absence of overtime and RN assignment to a single ICU patient.
AHRQ-funded; HS026370.
Citation: Womack DM, Miech EJ, Fox NJ .
Coincidence analysis: a novel approach to modeling nurses' workplace experience.
Appl Clin Inform 2022 Aug;13(4):794-802. doi: 10.1055/s-0042-1756368..
Keywords: Provider: Nurse, Workflow
Mojica CM, Gunn R, Pham R
An observational study of workflows to support fecal testing for colorectal cancer screening in primary care practices serving Medicaid enrollees.
This study was conducted to describe clinical workflows for fecal immunochemical tests/fecal occult blood tests (FIT/FOBT) in Oregon primary care practices and to identify specific workflow processes that might be associated with higher colorectal cancer (CRC) screening rates. Findings showed that primary care practices with higher CRC screening rates among newly age-eligible Medicaid enrollees had more established visit-based and population outreach workflows to support identifying patients due for screening, FIT/FOBT distribution, reminders, and follow up. Higher CRC screening was associated with having medical assistants discuss and review FIT/FOBT screening and instructions with patients.
AHRQ-funded; HS022981.
Citation: Mojica CM, Gunn R, Pham R .
An observational study of workflows to support fecal testing for colorectal cancer screening in primary care practices serving Medicaid enrollees.
BMC Cancer 2022 Jan 25;22(1):106. doi: 10.1186/s12885-021-09106-7..
Keywords: Workflow, Screening, Cancer: Colorectal Cancer, Cancer, Primary Care, Vulnerable Populations
Burden A, Potestio C, Pukenas E
Influence of perioperative handoffs on complications and outcomes.
The authors describe the perioperative environment, calling it dynamic and complex, and indicate that there are multiple distractions that can interfere with effective communication and safe patient care. They discuss various aspects involved in handoffs, concluding that an institutional culture that highlights the importance of patient safety and that encourages team collaboration has demonstrated that harm can be decreased and patient safety can be improved.
AHRQ-funded; HS026158.
Citation: Burden A, Potestio C, Pukenas E .
Influence of perioperative handoffs on complications and outcomes.
Adv Anesth 2021 Dec;39:133-48. doi: 10.1016/j.aan.2021.07.008..
Keywords: Patient Safety, Transitions of Care, Workflow
Johnson KD, Schumacher D, Lee RC
Identifying strategies for the management of interruptions for novice triage nurses using an online modified Delphi method.
This study’s purpose was to use the Delphi Method to identify strategies used by triage nurses to effectively manage interrupts that can be taught to novice nurses. A panel of nine triage, education, and operational management experts were selected. The panel participated in three Delphi rounds. Results were synthesized and summaries returned to the participants. A final consensus was reached regarding recommendations for successful strategies to address triage interruptions. Eight strategies to mitigate the impact of interruptions were identified. Six of those strategies were identified as best being taught using simulation.
AHRQ-funded; HS025844.
Citation: Johnson KD, Schumacher D, Lee RC .
Identifying strategies for the management of interruptions for novice triage nurses using an online modified Delphi method.
J Nurs Scholarsh 2021 Nov;53(6):718-26. doi: 10.1111/jnu.12683..
Keywords: Nursing, Workflow
Salwei ME, Carayon P, Hoonakker PLT
Workflow integration analysis of a human factors-based clinical decision support in the emergency department.
Numerous challenges with the implementation, acceptance, and use of health IT are related to poor usability and a lack of integration of the technologies into clinical workflow, and have, therefore, limited the potential of these technologies to improve patient safety. In this paper, the investigators propose a definition and conceptual model of health IT workflow integration. Using interviews of 12 emergency department (ED) physicians, they identified 134 excerpts of barriers and facilitators to workflow integration of a human factors (HF)-based clinical decision support (CDS) implemented in the ED.
AHRQ-funded; HS022086.
Citation: Salwei ME, Carayon P, Hoonakker PLT .
Workflow integration analysis of a human factors-based clinical decision support in the emergency department.
Appl Ergon 2021 Nov;97:103498. doi: 10.1016/j.apergo.2021.103498..
Keywords: Emergency Department, Workflow, Clinical Decision Support (CDS), Health Information Technology (HIT), Implementation
Benneyan JC, White T, Nehls N
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
This paper is a systems analysis of a dedicated ambulatory respiratory unit for patients with COVID-19 symptoms. Workflow redesigns were necessitated by COVID and included new ambulatory workflows to handle surge volumes, protect patients and staff, and ensure timely reliable care. The workflow innovations observed can possibly be used to benefit routine care. Observations found that more than 85% of follow-ups were completed within 24 hours, and no staff or patient infections were associated with unit operations. Identified issues included role confusion, staffing and gatekeeping bottlenecks, and patient reluctance to visit in person or discuss concerns on the phone.
AHRQ-funded; HS027282.
Citation: Benneyan JC, White T, Nehls N .
Systems analysis of a dedicated ambulatory respiratory unit for seeing and ensuring follow-up of patients with COVID-19 symptoms.
J Ambul Care Manage 2021 Oct-Dec;44(4):293-303. doi: 10.1097/jac.0000000000000390..
Keywords: COVID-19, Ambulatory Care and Surgery, Respiratory Conditions, Workflow, Healthcare Delivery
Joseph A, Neyens D, Mihandoust S
Impact of surgical table orientation on flow disruptions and movement patterns during pediatric outpatient surgeries.
This quantitative observational study observed the impacts of surgical table orientation on flow disruptions (FDs), the number of contacts between team members, and the distance traveled. Findings showed that the orientation of the surgical table significantly influenced staff workflow and movement in the operating room, with an angled surgical table orientation being the least disruptive to surgical work. The anesthesia provider, scrub nurse, and circulating nurse experienced more FDs compared to the surgeon.
AHRQ-funded; HS024380.
Citation: Joseph A, Neyens D, Mihandoust S .
Impact of surgical table orientation on flow disruptions and movement patterns during pediatric outpatient surgeries.
Int J Environ Res Public Health 2021 Jul 31;18(15). doi: 10.3390/ijerph18158114..
Keywords: Children/Adolescents, Ambulatory Care and Surgery, Surgery, Workflow
Hung DY, Mujal G, Jin A
Patient experiences after implementing lean primary care redesigns.
The authors examined the effect of Lean primary care redesigns on patient satisfaction with care and timeliness of care received. After implementation of Lean redesigns, they found that patients reported a 44.8 percent increase in satisfaction with the adequacy of time spent with care providers during office visits. They also reported 71.6 percent higher satisfaction with their care provider's ability to listen to their concerns and a 55.4 percent increase in perceived staff helpfulness at the visit. The amount of time elapsed between a patient request for a routine appointment and the scheduled visit day decreased. On the day of the visit, patient wait times to be seen also decreased gradually.
AHRQ-funded; HS024529.
Citation: Hung DY, Mujal G, Jin A .
Patient experiences after implementing lean primary care redesigns.
Health Serv Res 2021 Jun;56(3):363-70. doi: 10.1111/1475-6773.13605..
Keywords: Patient Experience, Primary Care: Models of Care, Primary Care, Workflow, Quality Improvement, Quality of Care
Freedman S, Golberstein E, Huang TY
Docs with their eyes on the clock? The effect of time pressures on primary care productivity.
J Health Econ 2021 May;77:102442. doi: 10.1016/j.jhealeco.2021.102442.
Investigators examined how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. Data was taken from the electronic health records of a large integrated delivery system. They found that greater time pressure reduced the number of diagnoses recorded during a visit and increased both scheduled and unscheduled follow-up care. Further, they found evidence of increased low-value care, decreased preventive care, and decreased opioid prescribing.
Investigators examined how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. Data was taken from the electronic health records of a large integrated delivery system. They found that greater time pressure reduced the number of diagnoses recorded during a visit and increased both scheduled and unscheduled follow-up care. Further, they found evidence of increased low-value care, decreased preventive care, and decreased opioid prescribing.
AHRQ-funded; HS000036.
Citation: Freedman S, Golberstein E, Huang TY .
Docs with their eyes on the clock? The effect of time pressures on primary care productivity.
J Health Econ 2021 May;77:102442. doi: 10.1016/j.jhealeco.2021.102442..
Keywords: Primary Care, Healthcare Delivery, Workflow
Linke SE, Kallenberg GR, Kronick R
Integrating "Exercise Is Medicine" into primary care workflow: a study protocol.
As a major contributor to the burden of most chronic diseases, insufficient physical activity (PA) creates a significant financial burden on the health care system. Exercise Is Medicine (EIM) is a global health initiative committed to the belief that PA is integral to the prevention and treatment of diseases and should be routinely assessed as a vital sign and treated in the health care setting. This paper described an in-progress embedded quality improvement (QI) project that integrated EIM into routine clinical practice.
AHRQ-funded; HS026517.
Citation: Linke SE, Kallenberg GR, Kronick R .
Integrating "Exercise Is Medicine" into primary care workflow: a study protocol.
Transl Behav Med 2021 Apr 26;11(4):921-29. doi: 10.1093/tbm/ibaa088..
Keywords: Primary Care, Lifestyle Changes, Workflow, Healthcare Delivery
Jurewicz KA, Neyens DM, Catchpole K
Observational study of anaesthesia workflow to evaluate physical workspace design and layout.
The objective of this study was to observe the relationship between task switching and physical layout, and then use the data collected to design and assess different anesthesia workspace layouts. Six videos of anesthesia providers from a single medical center in the United States were analyzed. Findings showed that current operating theater layouts do not fit work demands. The authors reported a simple method that facilitates a quick layout design assessment and showed that the anesthesia workspace can be improved to better suit workflow and patient care. They suggested that this arrangement could reduce anesthesia workload while improving task flow efficiency and potentially the safety of care.
AHRQ-funded; HS024380.
Citation: Jurewicz KA, Neyens DM, Catchpole K .
Observational study of anaesthesia workflow to evaluate physical workspace design and layout.
Br J Anaesth 2021 Mar;126(3):633-41. doi: 10.1016/j.bja.2020.08.063..
Keywords: Workflow, Healthcare Delivery, Surgery
Hung DY, Truong QA, Liang SY
Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks.
Investigators examined 3-year impacts of Lean implementation on the amount of time taken for physicians to complete common clinical tasks. They found that Lean redesigns led to improvements in timely completion of 3 out of 4 common clinical tasks, thus supporting the use of Lean techniques to engage teams in routine aspects of patient care. They recommended more research to understand the mechanisms by which Lean promotes quality improvement and effectiveness of care team workflows.
AHRQ-funded; HS024529.
Citation: Hung DY, Truong QA, Liang SY .
Implementing lean quality improvement in primary care: impact on efficiency in performing common clinical tasks.
J Gen Intern Med 2021 Feb;36(2):274-79. doi: 10.1007/s11606-020-06317-9..
Keywords: Primary Care, Quality Improvement, Quality of Care, Primary Care: Models of Care, Primary Care, Implementation, Workflow, Teams, Healthcare Delivery
Patel VL, Denton CA, Soni HC
Physician workflow in two distinctive emergency departments: an observational study.
In this study, the investigators characterized physician workflow in two distinctive emergency departments (ED). Physician practices mediated by electronic health records (EHR) were explored within the context of organizational complexity for the delivery of care. The investigators concluded that 1.) the nature of the clinical practice and EHR-mediated workflow reflected the ED work practices; 2.) physicians in more complex organizations may be less efficient because of the fragmented workflow- however these effects could be mitigated by effort distribution through team communication, which affords inherent safety checks.
AHRQ-funded; HS022670.
Citation: Patel VL, Denton CA, Soni HC .
Physician workflow in two distinctive emergency departments: an observational study.
Appl Clin Inform 2021 Jan;12(1):141-52. doi: 10.1055/s-0040-1722615..
Keywords: Emergency Department, Workflow, Healthcare Delivery, Electronic Health Records (EHRs), Health Information Technology (HIT)
Senathirajah Y, Kaufman DR, Cato KD
Characterizing and visualizing display and task fragmentation in the electronic health record: mixed methods design.
The complexity of health care data and workflow presents challenges to the study of usability in electronic health records (EHRs). This study aimed to define and analyze some of the main sources of fragmentation in EHR user interfaces (UIs); discuss relevant theoretical, historical, and practical considerations; and use granular microanalytic methods and visualization techniques to help us understand the nature of fragmentation and opportunities for EHR optimization or redesign.
AHRQ-funded; HS023708.
Citation: Senathirajah Y, Kaufman DR, Cato KD .
Characterizing and visualizing display and task fragmentation in the electronic health record: mixed methods design.
JMIR Hum Factors 2020 Oct 21;7(4):e18484. doi: 10.2196/18484..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Workflow, System Design
Gold JA, Becton J, Ash JS
Do you know what your scribe did last spring? The impact of COVID-19 on medical scribe workflow.
This study assessed the impact of COVID-19 on the workflow of medical scribes. This prospective observational study was conducted at an academic medical center in the United States. A total of 74 scribes working in ambulatory practices were recruited, with 57 scribes completing the survey. Overall, 42% of scribes transitioned to remote scribing with 97% serving as remote scribes for telehealth visits. These scribes worked at home and used personal equipment. Of those no longer working as scribes, 46% worked in preclinic support, with a wide range of EHR-related activities reported. The remainder were either redeployed or furloughed.
AHRQ-funded; HS025141.
Citation: Gold JA, Becton J, Ash JS .
Do you know what your scribe did last spring? The impact of COVID-19 on medical scribe workflow.
Appl Clin Inform 2020 Oct;11(5):807-11. doi: 10.1055/s-0040-1721396..
Keywords: COVID-19, Workflow, Electronic Health Records (EHRs), Telehealth, Health Information Technology (HIT)
Ramly E, Tong M, Bondar S
Workflow barriers and strategies to reduce antibiotic overuse in nursing homes.
Antibiotic overuse is a significant problem in nursing homes (NHs). Strategies to improve antibiotic prescribing practices in NHs are a critical need. In this study, the investigators analyzed antibiotic prescribing workflows to identify strategies for improving antibiotic prescribing in NHs. They found that such strategies included structured information tools, nurse and prescriber education, and organizational improvement.
AHRQ-funded; HS022465.
Citation: Ramly E, Tong M, Bondar S .
Workflow barriers and strategies to reduce antibiotic overuse in nursing homes.
J Am Geriatr Soc 2020 Oct;68(10):2222-31. doi: 10.1111/jgs.16632..
Keywords: Workflow, Antibiotics, Medication, Nursing Homes, Long-Term Care, Elderly, Antimicrobial Stewardship, Practice Patterns
Daly Guris RJ, Doshi A, Boyer DL
Just-in-time simulation to guide workflow design for coronavirus disease 2019 difficult airway management.
This paper describes the development and enactment of a number of simulation exercises, increasing in complexity for clinicians to practice intubation of critically ill children while wearing personal protective equipment due to coronavirus disease. The simulations ended up aiding in a real-life situation that then occurred less than 12 hours later that validated potential failure points and effectiveness of rapidly generated guidance. From this simulation a COVID-19 airway bundle template was created.
AHRQ-funded; HS026939; HS024511.
Citation: Daly Guris RJ, Doshi A, Boyer DL .
Just-in-time simulation to guide workflow design for coronavirus disease 2019 difficult airway management.
Pediatr Crit Care Med 2020 Aug;21(8):e485-e90. doi: 10.1097/pcc.0000000000002435..
Keywords: Children/Adolescents, COVID-19, Respiratory Conditions, Workflow, Simulation, Training
