Evidence map›Paper›PMID 33002331›Full record

ArticleCancer medicine2020

Computer-based simulation to reduce EHR-related chemotherapy ordering errors.

Kirk D Wyatt, Elizabeth B Freedman, Grace M Arteaga, Vilmarie Rodriguez, Deepti M Warad

Abstract read
In one paragraph

Article in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kirk D WyattDivision of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-3856-2055
Elizabeth B FreedmanDivision of Pharmacy, Mayo Clinic, Rochester, MN, USA.
Grace M ArteagaDivision of Pediatric Critical Care, Mayo Clinic, Rochester, MN, USA.
Vilmarie RodriguezDivision of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN, USA.
Deepti M WaradDivision of Pediatric Hematology/Oncology, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-1899-5208

Funding

Mayo Clinic Center for Clinical and Translational Science (CCaTS UL1 Supplement - Dr. Timothy Curry)UL1TR002377 · NCATS · MAYO CLINIC ROCHESTER · PI VESNA D GAROVIC · 2017 to 2026
$78.4M
NCATS NIH HHS UL1 TR002377
6 · The paper itself

Abstract

backgroundThe electronic health record (EHR) is a contributor to serious patient harm occurring within a sociotechnical system. Chemotherapy ordering is a high-risk task due to the complex nature of ordering workflows and potential detrimental effects if wrong chemotherapeutic doses are administered. Many chemotherapy ordering errors cannot be mitigated through systems-based changes due to the limited extent to which individual institutions are able to customize proprietary EHR software. We hypothesized that simulation-based training could improve providers' ability to identify and mitigate common chemotherapy ordering errors.

methodsPediatric hematology/oncology providers voluntarily participated in simulations using an EHR testing ("Playground") environment. The number of safety risks identified and mitigated by each provider at baseline was recorded. Risks were reviewed one-on-one after initial simulations and at a group "lunch-and-learn" session. At three-month follow-up, repeat simulations assessed for improvements in error identification and mitigation, and providers were surveyed about prevention of real-life safety events.

resultsThe 8 participating providers identified and mitigated an average of 5.5 out of 10 safety risks during the initial simulation, compared 7.4 safety risks at the follow up simulation (p=0.030). Two of the providers (25%) reported preventing at least one real-world patient safety event in the clinical setting as a result of the initial training session.

conclusionsSimulation-based training may reduce providers' susceptibility to chemotherapy ordering safety vulnerabilities within the EHR. This approach may be used when systems-based EHR improvements are not feasible due to limited ability to customize local instances of proprietary EHR software.

Indexed as

Electronic Health RecordsHigh Fidelity Simulation TrainingMedication SystemsRisk Evaluation and MitigationAntineoplastic AgentsClinical CompetenceCoagulantsDrug Therapy, Computer-AssistedHumansMedication ErrorsPatient SafetyRisk AssessmentRisk FactorsWorkflowAntineoplastic AgentsCoagulantselectronic health recordshigh fidelity simulation trainingmedical informaticspatient harmpatient safetysimulation training

Identifiers

PMID33002331
PMCPMC7724293

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.