Evidence map›Paper›PMID 38196684›Full record

ArticleATS scholar2023

Development and Implementation of an Escalation Protocol for Internal Medicine Trainees.

Seda Babroudi, Sharanya Mohanty, Aliysa Rajwani, Leidy Guzman, Langley Topper, Samantha Asber, Karen Freund, Sucharita Kher

Abstract read
In one paragraph

Article in ATS scholar, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

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

2 citing papers in PubMed.

  1. Article
  2. 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

8 authors.

Seda BabroudiDepartment of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.ORCID https://orcid.org/0000-0001-6652-1309
Sharanya MohantyDepartment of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
Aliysa RajwaniDepartment of Quality and Patient Safety, Mount Auburn Hospital, Cambridge, Massachusetts.
Leidy GuzmanDepartment of Quality and Patient Safety.
Langley TopperDepartment of Quality and Patient Safety.
Samantha AsberDepartment of Nursing, and.
Karen FreundDepartment of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
Sucharita KherDepartment of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.ORCID https://orcid.org/0000-0002-3051-6441

Funding

CTSA Graduate ProgramTL1TR002546 · NCATS · TUFTS UNIVERSITY BOSTON · PI KENT, DAVID M · 2018 to 2022
$4.2M
NCATS NIH HHS TL1 TR002546
6 · The paper itself

Abstract

Background: Overnight, physicians in training receive less direct supervision. Decreased direct supervision requires trainees to appropriately assess patients at risk of clinical deterioration and escalate to supervising physicians. Failure of trainees to escalate contributes to adverse patient safety events. Objective: To standardize the evaluation of patients at risk of deterioration overnight by internal medicine residents, increase communication between residents and supervising physicians, and improve perceptions of patient safety at a tertiary academic medical center. Methods: A multidisciplinary stakeholder team developed an overnight escalation-of-care protocol for residents. The protocol was implemented with badge buddies and an educational campaign targeted at residents, supervising physicians, and nursing staff. Residents and supervising physicians completed anonymous surveys to assess the use of the protocol; the frequency of overnight communication between residents and supervising physicians; and perceptions of escalation and patient safety before, immediately after ("early postintervention"), and 8 months after ("delayed postintervention") the intervention. Results: Seventy-five (100%) residents participated in the intervention, and 57-89% of those invited to complete surveys at the various time points responded. After the intervention, 82% of residents reported using the protocol, though no change was observed in the frequency of communication between residents and supervising physicians. After the implementation, residents perceived that patient care was safer (early postintervention, 47%; delayed postintervention, 72%; Conclusion: An escalation-of-care protocol was developed and successfully implemented using a multimodal approach. The implementation and dissemination of the protocol standardized resident escalation overnight and improved resident-perceived patient safety and interns' comfort with escalation.

Indexed as

clinical deteriorationcommunicationescalation of carepatient safetyresidency training

Identifiers

PMID38196684
PMCPMC10773492

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.