Evidence map›Paper›PMID 35545126›Full record

ArticleApplied clinical informatics2022

Reporting Outcomes of Pediatric Intensive Care Unit Patients to Referring Physicians via an Electronic Health Record-Based Feedback System.

Christina L Cifra, Cody R Tigges, Sarah L Miller, Nathaniel Curl, Christopher D Monson, Kimberly C Dukes, Heather S Reisinger, Priyadarshini R Pennathur, Dean F Sittig, Hardeep Singh

Registry-linked trialAbstract read
In one paragraph

Article in Applied clinical informatics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04166240 (Measuring and Improving the Safety of Test Result Follow-Up), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

NCT04166240 nacompletednot on this map

Measuring and Improving the Safety of Test Result Follow-Up

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2018 to 2023Enrolled46ConditionsLung Cancer, Breast Cancer, Colon Cancer, Bladder CancerArmsSAFER TRACKS Intervention
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  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

10 authors.

Christina L CifraDepartment of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.
Cody R TiggesDepartment of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.
Sarah L MillerDepartment of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.
Nathaniel CurlEmergency Medicine, UnityPoint Health-Trinity Medical Center, Rock Island, Illinois, United States.
Christopher D MonsonDepartment of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.
Kimberly C DukesCenter for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa, United States.
Heather S ReisingerCenter for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa, United States.
Priyadarshini R PennathurDepartment of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States.
Dean F SittigSchool of Biomedical Informatics, Center for Healthcare Quality and Safety, University of Texas Health Science Center, Houston, Texas, United States.
Hardeep SinghCenter for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, United States.

Funding

The University of Iowa Clinical and Translational Science AwardUL1TR002537 · NCATS · UNIVERSITY OF IOWA · PI HANSEN, MARLAN R, WINOKUR, PATRICIA · 2018 to 2022
$20.0M
Application of a Machine Learning to Enhance e-Triggers to Detect and Learn from Diagnostic Safety EventsR01HS027363 · AHRQ · BAYLOR COLLEGE OF MEDICINE · PI SINGH, HARDEEP · 2019 to 2021
$1.5M
Understanding Referral Communication, the Diagnostic Process, and Diagnostic Error in Pediatric Critical CareK08HS026965 · AHRQ · UNIVERSITY OF IOWA · PI CIFRA, CHRISTINA LUZ L · 2020 to 2022
$440k
AHRQ HHS K08 HS026965AHRQ HHS R01 HS027363NCATS NIH HHS UL1 TR002537
6 · The paper itself

Abstract

backgroundMany critically ill children are initially evaluated in front-line settings by clinicians with variable pediatric training before they are transferred to a pediatric intensive care unit (PICU). Because clinicians learn from past performance, communicating outcomes of patients back to front-line clinicians who provide pediatric emergency care could be valuable; however, referring clinicians do not consistently receive this important feedback.

objectivesOur aim was to determine the feasibility, usability, and clinical relevance of a semiautomated electronic health record (EHR)-supported system developed at a single institution to deliver timely and relevant PICU patient outcome feedback to referring emergency department (ED) physicians.

methodsGuided by the Health Information Technology Safety Framework, we iteratively designed, implemented, and evaluated a semiautomated electronic feedback system leveraging the EHR in one institution. After conducting interviews and focus groups with stakeholders to understand the PICU-ED health care work system, we designed the EHR-supported feedback system by translating stakeholder, organizational, and usability objectives into feedback process and report requirements. Over 6 months, we completed three cycles of implementation and evaluation, wherein we analyzed EHR access logs, reviewed feedback reports sent, performed usability testing, and conducted physician interviews to determine the system's feasibility, usability, and clinical relevance.

resultsThe EHR-supported feedback process is feasible with timely delivery and receipt of feedback reports. Usability testing revealed excellent Systems Usability Scale scores. According to physicians, the process was well-integrated into their clinical workflows and conferred minimal additional workload. Physicians also indicated that delivering and receiving consistent feedback was relevant to their clinical practice.

conclusionAn EHR-supported system to deliver timely and relevant PICU patient outcome feedback to referring ED physicians was feasible, usable, and important to physicians. Future work is needed to evaluate impact on clinical practice and patient outcomes and to investigate applicability to other clinical settings involved in similar care transitions.

Indexed as

Electronic Health RecordsPhysiciansChildFeedbackHumansIntensive Care Units, PediatricWorkload

Identifiers

PMID35545126
PMCPMC9095343

What OpenQuestion holds

Textmetadata
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Registered trials

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.