Evaluating the safety and patient impacts of an artificial intelligence command centre in acute hospital care: a mixed-methods protocol

Abstract

IntroductionThis paper presents a mixed-methods study protocol that will be used to evaluate a recent implementation of a real-time, centralised hospital command centre in the UK. The command centre represents a complex intervention within a complex adaptive system. It could support better operational decision-making and facilitate identification and mitigation of threats to patient safety. There is, however, limited research on the impact of such complex health information technology on patient safety, reliability and operational efficiency of healthcare delivery and this study aims to help address that gap.Methods and analysisWe will conduct a longitudinal mixed-method evaluation that will be informed by public-and-patient involvement and engagement. Interviews and ethnographic observations will inform iterations with quantitative analysis that will sensitise further qualitative work. Quantitative work will take an iterative approach to identify relevant outcome measures from both the literature and pragmatically from datasets of routinely collected electronic health records.Ethics and disseminationThis protocol has been approved by the University of Leeds Engineering and Physical Sciences Research Ethics Committee (#MEEC 20-016) and the National Health Service Health Research Authority (IRAS No.: 285933). Our results will be communicated through peer-reviewed publications in international journals and conferences. We will provide ongoing feedback as part of our engagement work with local trust stakeholders.

Effect of a hospital command centre on patient safety: an interrupted time series study

“…This is a retrospective population-based cohort study undertaken as part of a mixed method evaluation project with a formal evaluation protocol published by the authors in January 2022. 12 Qualitative study of the command centre programme gave rise to two hypothesised intervention timelines, one focusing on the implementation and activation of the technological components of the command centre and the other ‘complex’ intervention model that sought to account for the broader patient flow and operational redesign programme in which the command centre technology was a part. For the technology model, a three-phase, interrupted time series model was used to reflect incremental implementation of the visual displays in the command centre, consisting of a preintervention (baseline), first intervention component (‘command centre displays roll-in’) and second intervention component (‘command centre activation’).…”

“…Details of the wider project’s patient and public involvement and engagement are available in the published protocol. 12 …”

“…Potential patient safety outcome indicators were listed in our published protocol. 12 However, due to data availability, three indicators for the BRI hospital (mortality, readmissions within 72 hours and postoperative sepsis) and two indicators for the CHH (mortality and readmissions within 72 hours) were analysed.…”

“…This is a retrospective population-based cohort study undertaken as part of a mixed method evaluation project with a formal evaluation protocol published by the authors in January 2022 12. Qualitative study of the command centre programme gave rise to two hypothesised intervention timelines, one focusing on the implementation and activation of the technological components of the command centre and the other ‘complex’ intervention model that sought to account for the broader patient flow and operational redesign programme in which the command centre technology was a part.…”

“…Public and patient representatives contributed to the development of the research protocol and towards selection of proxy patient safety outcomes. Details of the wider project’s patient and public involvement and engagement are available in the published protocol 12…”