Publications

Can a Novel ICU Data Display Positively Affect Patient Outcomes and Save Lives?

ABSTRACT - The aim of this study was to quantify the impact of ProCCESs AWARE, Ambient Clinical Analytics, Rochester, MN, a novel acute care electronic medical record interface, on a range of care process and patient health outcome metrics in intensive care units (ICUs). ProCCESs AWARE is a novel acute care EMR interface that contains built-in tools for error prevention, practice surveillance, decision support and reporting. We compared outcomes before and after AWARE implementation using a prospective cohort and a historical control....

Effect of daily use of electronic checklist on physical rehabilitation consultations in critically ill patients.

ABSTRACT - RATIONALE: In intensive care unit (ICU) practice, great emphasis is placed on the functional stabilization of the major organ systems, sometimes at the expense of physical rehabilitation. Checklists have shown to be an effective tool for standardizing care models. Our aim was to the study the effect of the use of an electronic checklist on occupational therapy/physical therapy (OT-PT) consults in critically ill patients....

Automatic quality improvement reports in the intensive care unit: One step closer toward meaningful use.

Abstract AIM: To examine the feasibility and validity of electronic generation of quality metrics in the intensive care unit (ICU). METHODS: This minimal risk observational study was performed at an academic tertiary hospital. The Critical Care Independent Multidisciplinary Program at Mayo Clinic identified and defined 11 key quality metrics....

The Effect of an Electronic Checklist on Critical Care Provider Workload, Errors, and Performance.

ABSTRACT - PURPOSE: The strategy used to improve effective checklist use in intensive care unit (ICU) setting is essential for checklist success. This study aimed to test the hypothesis that an electronic checklist could reduce ICU provider workload, errors, and time to checklist completion, as compared to a paper checklist. METHODS: This was a simulation-based study conducted at an academic tertiary hospital....

Development and Implementation of Sepsis Alert Systems.

ABSTRACT - Development and implementation of sepsis alert systems is challenging, particularly outside the monitored intensive care unit (ICU) setting. Barriers to wider use of sepsis alerts include evolving clinical definitions of sepsis, information overload, and alert fatigue, due to suboptimal alert performance. Outside the ICU, barriers include differences in health care delivery models, charting behaviors, and availability of electronic data....

User perception and experience of the introduction of a novel critical care patient viewer in the ICU setting.

ABSTRACT - OBJECTIVE: Failure to rapidly identify high-value information due to inappropriate output may alter user acceptance and satisfaction. The information needs for different intensive care unit (ICU) providers are not the same. This can obstruct successful implementation of electronic medical record (EMR) systems....

The implementation of clinician designed, human-centered electronic medical record viewer in the intensive care unit: a pilot step-wedge cluster randomized trial.

ABSTRACT - OBJECTIVES: AWARE (Ambient Warning and Response Evaluation) is a novel electronic medical record (EMR) dashboard designed by clinicians to support bedside clinical information management in the ICU. AWARE sits on top of pre-existing, comprehensive EMR systems. The purpose of the study was to test the acceptance and impact of AWARE on data management in live clinical ICU settings....

Developing the surveillance algorithm for detection of failure to recognize and treat severe sepsis.

ABSTRACT - OBJECTIVE: To develop and test an automated surveillance algorithm (sepsis "sniffer") for the detection of severe sepsis and monitoring failure to recognize and treat severe sepsis in a timely manner. PATIENTS AND METHODS: We conducted an observational diagnostic performance study using independent derivation and validation cohorts from an electronic medical record database of the medical intensive care unit (ICU) of a tertiary referral center. All patients aged 18 years and older who were admitted to the medical ICU from January 1 through March 31, 2013 (N=587), were included....

Clinical data needs in the neonatal intensive care unit electronic medical record.

ABSTRACT - BACKGROUND: The amount of clinical information that providers encounter daily creates an environment for information overload and medical error. To create a more efficient EMR human-computer interface, we aimed to understand clinical information needs among NICU providers. METHODS: A web-based survey to evaluate 98 data items was created and distributed to NICU providers....

Customized reference ranges for laboratory values decrease false positive alerts in intensive care unit patients.

ABSTRACT - BACKGROUND: Traditional electronic medical record (EMR) interfaces mark laboratory tests as abnormal based on standard reference ranges derived from healthy, middle-aged adults. This yields many false positive alerts with subsequent alert-fatigue when applied to complex populations like hospitalized, critically ill patients. Novel EMR interfaces using adjusted reference ranges customized for specific patient populations may ameliorate this problem....

Information needs for the OR and PACU electronic medical record.

ABSTRACT - OBJECTIVE: The amount of clinical information that anesthesia providers encounter creates an environment for information overload and medical error. In an effort to create more efficient OR and PACU EMR viewer platforms, we aimed to better understand the intraoperative and post-anesthesia clinical information needs among anesthesia providers. MATERIALS AND METHODS: A web-based survey to evaluate 75 clinical data items was created and distributed to all anesthesia providers at our institution....

Data utilization for medical decision making at the time of patient admission to ICU.

ABSTRACT - OBJECTIVES: Information overload in electronic medical records can impede providers' ability to identify important clinical data and may contribute to medical error. An understanding of the information requirements of ICU providers will facilitate the development of information systems that prioritize the presentation of high-value data and reduce information overload. Our objective was to determine the clinical information needs of ICU physicians, compared to the data available within an electronic medical record....

The effect of two different electronic health record user interfaces on intensive care provider task load, errors of cognition, and performance.

ABSTRACT- The care of critically ill patients generates large quantities of data. Increasingly, these data are presented to the provider within an electronic medical record. The manner in which data are organized and presented can impact on the ability of users to synthesis that data into meaningful information....

Enrollment into a time sensitive clinical study in the critical care setting: results from computerized septic shock sniffer implementation.

ABSTRACT - OBJECTIVE: Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock....

Novel Representation of Clinical Information in the ICU: Developing User Interfaces which Reduce Information Overload.

ABSTRACT- The introduction of electronic medical records (EMR) and computerized physician order entry (CPOE) into the intensive care unit (ICU) is transforming the way health care providers currently work. The challenge facing developers of EMR's is to create products which add value to systems of health care delivery. As EMR's become more prevalent, the potential impact they have on the quality and safety, both negative and positive, will be amplified....

Identification of patient information corruption in the intensive care unit: using a scoring tool to direct quality improvements in handover.

ABSTRACT - OBJECTIVE: To use a handover assessment tool for identifying patient information corruption and objectively evaluating interventions designed to reduce handover errors and improve medical decision making. The continuous monitoring, intervention, and evaluation of the patient in modern intensive care unit practice generates large quantities of information, the platform on which medical decisions are made. Information corruption, defined as errors of distortion/omission compared with the medical record, may result in medical judgment errors....