Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting
Background Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to seve...
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| Format: | Article |
| Language: | English |
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PeerJ Inc.
2017-03-01
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| Series: | PeerJ |
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| Online Access: | https://peerj.com/articles/3083.pdf |
| _version_ | 1797419148727287808 |
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| author | Andrew M. Harrison Charat Thongprayoon Christopher A. Aakre Jack Y. Jeng Mikhail A. Dziadzko Ognjen Gajic Brian W. Pickering Vitaly Herasevich |
| author_facet | Andrew M. Harrison Charat Thongprayoon Christopher A. Aakre Jack Y. Jeng Mikhail A. Dziadzko Ognjen Gajic Brian W. Pickering Vitaly Herasevich |
| author_sort | Andrew M. Harrison |
| collection | DOAJ |
| description | Background Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148) and 51% (N = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5) and median 2 min (N = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting. |
| first_indexed | 2024-03-09T06:43:02Z |
| format | Article |
| id | doaj.art-0d4467c6b655486e8a405a2402183386 |
| institution | Directory Open Access Journal |
| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T06:43:02Z |
| publishDate | 2017-03-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-0d4467c6b655486e8a405a24021833862023-12-03T10:41:41ZengPeerJ Inc.PeerJ2167-83592017-03-015e308310.7717/peerj.3083Comparison of methods of alert acknowledgement by critical care clinicians in the ICU settingAndrew M. Harrison0Charat Thongprayoon1Christopher A. Aakre2Jack Y. Jeng3Mikhail A. Dziadzko4Ognjen Gajic5Brian W. Pickering6Vitaly Herasevich7Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States of AmericaDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, United States of AmericaDepartment of Internal Medicine, Mayo Clinic, Rochester, MN, United States of AmericaMayo Medical School, Mayo Clinic, Rochester, MN, United States of AmericaDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, United States of AmericaDivision of Pulmonology and Critical Care Medicine, Mayo Clinic, Rochester, MN, United States of AmericaDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, United States of AmericaDepartment of Anesthesiology, Mayo Clinic, Rochester, MN, United States of AmericaBackground Electronic Health Record (EHR)-based sepsis alert systems have failed to demonstrate improvements in clinically meaningful endpoints. However, the effect of implementation barriers on the success of new sepsis alert systems is rarely explored. Objective To test the hypothesis time to severe sepsis alert acknowledgement by critical care clinicians in the ICU setting would be reduced using an EHR-based alert acknowledgement system compared to a text paging-based system. Study Design In one arm of this simulation study, real alerts for patients in the medical ICU were delivered to critical care clinicians through the EHR. In the other arm, simulated alerts were delivered through text paging. The primary outcome was time to alert acknowledgement. The secondary outcomes were a structured, mixed quantitative/qualitative survey and informal group interview. Results The alert acknowledgement rate from the severe sepsis alert system was 3% (N = 148) and 51% (N = 156) from simulated severe sepsis alerts through traditional text paging. Time to alert acknowledgement from the severe sepsis alert system was median 274 min (N = 5) and median 2 min (N = 80) from text paging. The response rate from the EHR-based alert system was insufficient to compare primary measures. However, secondary measures revealed important barriers. Conclusion Alert fatigue, interruption, human error, and information overload are barriers to alert and simulation studies in the ICU setting.https://peerj.com/articles/3083.pdfImplementation barriersAlert studiesSimulation studiesElectronic health recordIntensive care unitSepsis |
| spellingShingle | Andrew M. Harrison Charat Thongprayoon Christopher A. Aakre Jack Y. Jeng Mikhail A. Dziadzko Ognjen Gajic Brian W. Pickering Vitaly Herasevich Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting PeerJ Implementation barriers Alert studies Simulation studies Electronic health record Intensive care unit Sepsis |
| title | Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting |
| title_full | Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting |
| title_fullStr | Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting |
| title_full_unstemmed | Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting |
| title_short | Comparison of methods of alert acknowledgement by critical care clinicians in the ICU setting |
| title_sort | comparison of methods of alert acknowledgement by critical care clinicians in the icu setting |
| topic | Implementation barriers Alert studies Simulation studies Electronic health record Intensive care unit Sepsis |
| url | https://peerj.com/articles/3083.pdf |
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