Nurse, Patient, and Care Partner Perceptions of a Personalized Safety Plan Screensaver

Duckworth, Megan; Leung, Emily; Fuller, Theresa E.; Espares, Jenzel; Couture, Brittany; Chang, Frank Y.; Businger, Alexandra; Collins, Sarah A.; Dalal, Anuj K.; Fladger, Anne; Schnipper, Jeffrey L.; Schnock, Kumiko O.; Bates, David W.; Dykes, Patricia C.

doi:10.3928/00989134-20170313-05

Cited by 17 publications

(14 citation statements)

References 20 publications

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“…The PSLL project aimed to develop and implement a suite of HIT tools to engage patients and providers in improving quality and safety in the acute care setting. The HIT tools included a provider-facing safety dashboard [23], bedside safety display [24], and a patient portal (Figure 1). The provider-facing safety dashboard was used as a care team rounding tool and was only accessed by the health care providers [23].…”

Section: Methodsmentioning

confidence: 99%

“…The bedside safety display was both provider and patient facing. All patients were continuously exposed to the personalized bedside display monitor, whereas providers were intermittently exposed when in the patient room [24]. Randomly selected patients also received the patient portal that was a patient-facing tool accessed via a tablet computer or mobile device.…”

Section: Methodsmentioning

confidence: 99%

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Acute Care Patient Portal Intervention: Portal Use and Patient Activation

Schnock¹,

Snyder²,

Fuller³

et al. 2019

J Med Internet Res

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Background Patient-facing health information technology (HIT) tools, such as patient portals, are recognized as a potential mechanism to facilitate patient engagement and patient-centered care, yet the use of these tools remains limited in the hospital setting. Although research in this area is growing, it is unclear how the use of acute care patient portals might affect outcomes, such as patient activation. Objective The aim of this study was to describe the use of an acute care patient portal and investigate its association with patient and care partner activation in the hospital setting. Methods We implemented an acute care patient portal on 6 acute care units over an 18-month period. We investigated the characteristics of the users (patients and their care partners) of the patient portal, as well as their use of the portal. This included the number of visits to each page, the number of days used, the length of the user’s access period, and the average percent of days used during the access period. Patient and care partner activation was assessed using the short form of the patient activation measure (PAM-13) and the caregiver patient activation measure (CG-PAM). Comparisons of the activation scores were performed using propensity weighting and robust weighted linear regression. Results Of the 2974 randomly sampled patients, 59.01% (1755/2974) agreed to use the acute care patient portal. Acute care patient portal enrollees were younger, less sick, less likely to have Medicare as their insurer, and more likely to use the Partners Healthcare enterprise ambulatory patient portal (Patient Gateway). The most used features of the acute care patient portal were the laboratory test results, care team information, and medication list. Most users accessed the portal between 1 to 4 days during their hospitalization, and the average number of days used (logged in at least once per day) was 1.8 days. On average, users accessed the portal 42.69% of the hospital days during which it was available. There was significant association with patient activation on the neurology service ( P <.001) and medicine service ( P =.01), after the introduction of HIT tools and the acute care patient portal, but not on the oncology service. Conclusions Portal users most often accessed the portal to view their clinical information, though portal usage was limited to only the first few days of enrollment. We found an association between the use of the portal and HIT tools with improved levels of patient activation. These tools may help facilitate patient engagement and improve outcomes when fully utilized by patients and care partners. Future study should leverage usage metrics to describe portal use and assess the impact of HIT tools on specific outcome measures in the hospital setting.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Acute Care Patient Portal Intervention: Portal Use and Patient Activation

Schnock¹,

Snyder²,

Fuller³

et al. 2019

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…While a significant proportion of capacity-building interventions (eg, safety, rapid response teams) were implemented across entire acute care hospitals, other studies were directed towards specific patient populations, such as critically ill (n=7, 8.0%),35 52 56 71 73 85 97 geriatric (n=6, 6.9%),53 78 86 92 103 113 rehabilitation (n=9, 10.3%),48 69 70 89 97 104 108 116 117 surgical (n=6, 6.9%)64 72 109 112 113 or psychiatric (n=8, 9.2%)34 58 68 87 95 100 101 110 patients.…”

Section: Resultsmentioning

confidence: 99%

Building patient capacity to participate in care during hospitalisation: a scoping review

et al. 2019

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ObjectivesTo map the existing literature and describe interventions aimed at building the capacity of patients to participate in care during hospitalisation by: (1) describing and categorising the aspects of care targeted by these interventions and (2) identifying the behaviour change techniques (BCTs) used in these interventions. A patient representative participated in all aspects of this project.DesignScoping review.Data sourcesMEDLINE, Embase and CINAHL (Inception −2017).Study selectionStudies reporting primary research studies on building the capacity of hospitalised adult patients to participate in care which described or included one or more structured or systematic interventions and described the outcomes for at least the key stakeholder group were included.Data extractionTitle and abstract screening and full text screening were conducted by pairs of trained reviewers. One reviewer extracted data, which were verified by a second reviewer. Interventions were classified according to seven aspects of care relevant to hospital settings. BCTs identified in the articles were assigned through consensus of three reviewers.ResultsDatabase searches yielded a total 9899 articles, resulting in 87 articles that met the inclusion criteria. Interventions directed at building patient capacity to participate in care while hospitalised were categorised as those related to improving: patient safety (20.9%); care coordination (5.7%); effective treatment (5.7%) and/or patient-centred care using: bedside nursing handovers (5.7%); communication (29.1%); care planning (14%) or the care environment (19.8%). The majority of studies reported one or more positive outcomes from the defined intervention. Adding new elements (objects) to the environment and restructuring the social and/or physical environment were the most frequently identified BCTs.ConclusionsThe majority of studies to build capacity for participation in care report one or more positive outcomes, although a more comprehensive analysis is warranted.

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“…This automatically displays each patient’s fall prevention plan on the bedside monitor once a nurse has documented the risk assessment and tailored the fall prevention plan in the EHR. This level of automation provides a guarantee that the information displayed at the bedside is up-to-date and is a means of displaying the fall prevention plan in rooms that do not have a visible location to hang the Fall TIPS poster [17].…”

Section: Introductionmentioning

confidence: 99%

Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study

Duckworth¹,

Adelman²,

Belategui³

et al. 2019

J Med Internet Res

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BackgroundPatient falls are a major problem in hospitals. The development of a Patient-Centered Fall Prevention Toolkit, Fall TIPS (Tailoring Interventions for Patient Safety), reduced falls by 25% in acute care hospitals by leveraging health information technology to complete the 3-step fall prevention process—(1) conduct fall risk assessments; (2) develop tailored fall prevention plans with the evidence-based interventions; and (3) consistently implement the plan. We learned that Fall TIPS was most effective when patients and family were engaged in all 3 steps of the fall prevention process. Over the past decade, our team developed 3 Fall TIPS modalities—the original electronic health record (EHR) version, a laminated paper version that uses color to provide clinical decision support linking patient-specific risk factors to the interventions, and a bedside display version that automatically populates the bedside monitor with the patients’ fall prevention plan based on the clinical documentation in the EHR. However, the relative effectiveness of each Fall TIPS modality for engaging patients and family in the 3-step fall prevention process remains unknown.ObjectiveThis study aims to examine if the Fall TIPS modality impacts patient engagement in the 3-step fall prevention process and thus Fall TIPS efficacy.MethodsTo assess patient engagement in the 3-step fall prevention process, we conducted random audits with the question, “Does the patient/family member know their fall prevention plan?” In addition, audits were conducted to measure adherence, defined by the presence of the Fall TIPS poster at the bedside. Champions from 3 hospitals reported data from April to June 2017 on 6 neurology and 7 medical units. Peer-to-peer feedback to reiterate the best practice for patient engagement was central to data collection.ResultsOverall, 1209 audits were submitted for the patient engagement measure and 1401 for the presence of the Fall TIPS poster at the bedside. All units reached 80% adherence for both measures. While some units maintained high levels of patient engagement and adherence with the poster protocol, others showed improvement over time, reaching clinically significant adherence (>80%) by the final month of data collection.ConclusionsEach Fall TIPS modality effectively facilitates patient engagement in the 3-step fall prevention process, suggesting all 3 can be used to integrate evidence-based fall prevention practices into the clinical workflow. The 3 Fall TIPS modalities may prove an effective strategy for the spread, allowing diverse institutions to choose the modality that fits with the organizational culture and health information technology infrastructure.

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Nurse, Patient, and Care Partner Perceptions of a Personalized Safety Plan Screensaver

Cited by 17 publications

References 20 publications

Acute Care Patient Portal Intervention: Portal Use and Patient Activation

Acute Care Patient Portal Intervention: Portal Use and Patient Activation

Building patient capacity to participate in care during hospitalisation: a scoping review

Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study

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