Evidence map›Paper›PMID 39013194›Full record

Trial reportJournal of the American Medical Informatics Association : JAMIA2024

Effect of digital tools to promote hospital quality and safety on adverse events after discharge.

Anant Vasudevan, Savanna Plombon, Nicholas Piniella, Alison Garber, Maria Malik, Erin O'Fallon, Abhishek Goyal, Esteban Gershanik, Vivek Kumar, Julie Fiskio and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the American Medical Informatics Association : JAMIA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05232656 (Impact of an Epic-integrated Safety Dashboard and Interactive Pre-discharge Checklist on Post-discharge Adverse Events), which is not on this 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.

NCT05232656 nacompletednot on this map

Impact of an Epic-integrated Safety Dashboard and Interactive Pre-discharge Checklist on Post-discharge Adverse Events

TypeinterventionalSponsorBrigham and Women's HospitalRan2018 to 2020Enrolled268ConditionsTransitions of Care, General Medicine, Discharge Checklist, Adverse EventArmsPre-Discharge Checklist and Patient Safety Dashboard
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

14 authors.

Anant VasudevanDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.ORCID 0009-0004-9894-8576
Savanna PlombonDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Nicholas PiniellaDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Alison GarberDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Maria MalikDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Erin O'FallonDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Abhishek GoyalDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Esteban GershanikDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Vivek KumarDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Julie FiskioMass General Brigham, Boston, MA 02145, United States.
Cathy YoonDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Stuart R LipsitzDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Jeffrey L SchnipperDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
Anuj K DalalDivision of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.ORCID 0000-0003-1431-2972

Funding

CRICO
6 · The paper itself

Abstract

objectivesPost-discharge adverse events (AEs) are common and heralded by new and worsening symptoms (NWS). We evaluated the effect of electronic health record (EHR)-integrated digital tools designed to promote quality and safety in hospitalized patients on NWS and AEs after discharge. MATERIALS AND

methodsAdult general medicine patients at a community hospital were enrolled. We implemented a dashboard which clinicians used to assess safety risks during interdisciplinary rounds. Post-implementation patients were randomized to complete a discharge checklist whose responses were incorporated into the dashboard. Outcomes were assessed using EHR review and 30-day call data adjudicated by 2 clinicians and analyzed using Poisson regression. We conducted comparisons of each exposure on post-discharge outcomes and used selected variables and NWS as independent predictors to model post-discharge AEs using multivariable logistic regression.

resultsA total of 260 patients (122 pre, 71 post [dashboard], 67 post [dashboard plus discharge checklist]) enrolled. The adjusted incidence rate ratios (aIRR) for NWS and AEs were unchanged in the post- compared to pre-implementation period. For patient-reported NWS, aIRR was non-significantly higher for dashboard plus discharge checklist compared to dashboard participants (1.23 [0.97,1.56], P = .08). For post-implementation patients with an AE, aIRR for duration of injury (>1 week) was significantly lower for dashboard plus discharge checklist compared to dashboard participants (0 [0,0.53], P < .01). In multivariable models, certain patient-reported NWS were associated with AEs (3.76 [1.89,7.82], P < .01). DISCUSSION: While significant reductions in post-discharge AEs were not observed, checklist participants experiencing a post-discharge AE were more likely to report NWS and had a shorter duration of injury.

conclusionInterventions designed to prompt patients to report NWS may facilitate earlier detection of AEs after discharge. CLINICALTRIALS.GOV: NCT05232656.

Indexed as

ChecklistElectronic Health RecordsPatient DischargePatient SafetyAdultAgedFemaleHospitals, CommunityHumansMaleMiddle AgedQuality of Health Careadverse eventsdigital health toolsdischarge safetypatient-reported datapatient-reported symptoms

Identifiers

PMID39013194
PMCPMC11413445

What OpenQuestion holds

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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.