Evidence map›Paper›PMID 34589649›Full record

ArticlePediatric quality & safety

Improving Care Delivery: Location Timestamps to Enhance Process Measurement of a Clinical Workflow.

Lindsey Barrick, Danny T Y Wu, Theresa Frey, Derek Shu, Ruthvik Abbu, Stephen C Porter, Kevin M Overmann

Open access · diamondAbstract read
In one paragraph

Article in Pediatric quality & safety. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
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, 3 citations in OpenAlex.

  1. Article
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

7 authors at 2 institutions in 1 country.

Lindsey BarrickDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Danny T Y WuDepartment of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Theresa FreyDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Derek ShuDepartment of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Ruthvik AbbuDepartment of Biomedical Informatics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Stephen C PorterDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Kevin M OvermannDivision of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
University of Cincinnati Medical Center · USCincinnati Children's Hospital Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Traditional quality improvement (QI) strategies to describe workflow processes rely primarily upon qualitative methods or human-driven observations. These methods may be limited in scope and accuracy when applied to time-based workflow processes. This study sought to evaluate the utility of integrating objective time measurements to augment traditional QI strategies using procedural sedation workflow in a pediatric emergency department as an archetype.

methodsWe applied the FOCUS-Plan-Do-Check-Act framework to reduce the time from arrival to sedation for long-bone fractures. First, we added supplementary framework-defining steps to repeat the Clarifying and Understanding steps. We then extracted objective time-based data from an electronic health record (EHR) system and a real-time locating system (RTLS). We then compared and contrasted the findings of traditional surveys with analyses of timed steps within the sedation workflow.

resultsWhen identifying the source of delays, traditional survey techniques yielded ambiguous and even conflicting results based on clinical roles. The timestamps supported 5 measurable clinical role of subworkflows. By measuring the time to completion for 54 sedation cases, workflow patterns and significant bottlenecks were identified.

conclusionsAnalyzing the time to complete individual tasks provided a more nuanced description of workflow delays and clarity when traditional survey results conflicted. Augmenting traditional QI process maps with EHR and RTLS timestamps better explained workflow bottlenecks, informing the QI team when selecting targets for subsequent Plan-Do-Check-Act work.

Identifiers

PMID34589649
PMCPMC8476056
OpenAlexW3201728177

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.