Effect of a hospital command centre on patient safety: an interrupted time series study
Background Command centres have been piloted in some hospitals across the developed world in the last few years. Their impact on patient safety, however, has not been systematically studied. Hence, we aimed to investigate this.Methods This is a retrospective population-based cohort study. Participan...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-12-01
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| Series: | BMJ Health & Care Informatics |
| Online Access: | https://informatics.bmj.com/content/30/1/e100653.full |
| _version_ | 1797371042292826112 |
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| author | Rebecca Randell Ibrahim Habli Tom Lawton Jonathan Benn Teumzghi F Mebrahtu Carolyn McCrorie Ciarán D McInerney Josh Granger Naeem Sheikh Owen Ashby Johnson |
| author_facet | Rebecca Randell Ibrahim Habli Tom Lawton Jonathan Benn Teumzghi F Mebrahtu Carolyn McCrorie Ciarán D McInerney Josh Granger Naeem Sheikh Owen Ashby Johnson |
| author_sort | Rebecca Randell |
| collection | DOAJ |
| description | Background Command centres have been piloted in some hospitals across the developed world in the last few years. Their impact on patient safety, however, has not been systematically studied. Hence, we aimed to investigate this.Methods This is a retrospective population-based cohort study. Participants were patients who visited Bradford Royal Infirmary Hospital and Calderdale & Huddersfield hospitals between 1 January 2018 and 31 August 2021. A five-phase, interrupted time series, linear regression analysis was used.Results After introduction of a Command Centre, while mortality and readmissions marginally improved, there was no statistically significant impact on postoperative sepsis. In the intervention hospital, when compared with the preintervention period, mortality decreased by 1.4% (95% CI 0.8% to 1.9%), 1.5% (95% CI 0.9% to 2.1%), 1.3% (95% CI 0.7% to 1.8%) and 2.5% (95% CI 1.7% to 3.4%) during successive phases of the command centre programme, including roll-in and activation of the technology and preparatory quality improvement work. However, in the control site, compared with the baseline, the weekly mortality also decreased by 2.0% (95% CI 0.9 to 3.1), 2.3% (95% CI 1.1 to 3.5), 1.3% (95% CI 0.2 to 2.4), 3.1% (95% CI 1.4 to 4.8) for the respective intervention phases. No impact on any of the indicators was observed when only the software technology part of the Command Centre was considered.Conclusion Implementation of a hospital Command Centre may have a marginal positive impact on patient safety when implemented as part of a broader hospital-wide improvement programme including colocation of operations and clinical leads in a central location. However, improvement in patient safety indicators was also observed for a comparable period in the control site. Further evaluative research into the impact of hospital command centres on a broader range of patient safety and other outcomes is warranted. |
| first_indexed | 2024-03-08T18:13:10Z |
| format | Article |
| id | doaj.art-ea11f60db25646f3a241baa5a8077ac4 |
| institution | Directory Open Access Journal |
| issn | 2632-1009 |
| language | English |
| last_indexed | 2024-03-08T18:13:10Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Health & Care Informatics |
| spelling | doaj.art-ea11f60db25646f3a241baa5a8077ac42023-12-31T22:55:08ZengBMJ Publishing GroupBMJ Health & Care Informatics2632-10092023-12-0130110.1136/bmjhci-2022-100653Effect of a hospital command centre on patient safety: an interrupted time series studyRebecca Randell0Ibrahim Habli1Tom Lawton2Jonathan Benn3Teumzghi F Mebrahtu4Carolyn McCrorie5Ciarán D McInerney6Josh Granger7Naeem Sheikh8Owen Ashby Johnson94 Wolfson Centre for Applied Health Research, Bradford, UKDepartment of Computer Science, University of York, York, UKBradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK1University of Leeds, Leeds, UKSchool of Computing, University of Leeds, Leeds, UKWolfson Centre for Applied Health Research, Bradford Royal Infirmary, Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UKSchool of Computing, University of Leeds, Leeds, UKSchool of Psychology, University of Leeds, Leeds, West Yorkshire, UKWolfson Centre for Applied Health Research, Bradford Royal Infirmary, Yorkshire and Humber Patient Safety Translational Research Centre, Bradford, UKSchool of Computing, University of Leeds, Leeds, UKBackground Command centres have been piloted in some hospitals across the developed world in the last few years. Their impact on patient safety, however, has not been systematically studied. Hence, we aimed to investigate this.Methods This is a retrospective population-based cohort study. Participants were patients who visited Bradford Royal Infirmary Hospital and Calderdale & Huddersfield hospitals between 1 January 2018 and 31 August 2021. A five-phase, interrupted time series, linear regression analysis was used.Results After introduction of a Command Centre, while mortality and readmissions marginally improved, there was no statistically significant impact on postoperative sepsis. In the intervention hospital, when compared with the preintervention period, mortality decreased by 1.4% (95% CI 0.8% to 1.9%), 1.5% (95% CI 0.9% to 2.1%), 1.3% (95% CI 0.7% to 1.8%) and 2.5% (95% CI 1.7% to 3.4%) during successive phases of the command centre programme, including roll-in and activation of the technology and preparatory quality improvement work. However, in the control site, compared with the baseline, the weekly mortality also decreased by 2.0% (95% CI 0.9 to 3.1), 2.3% (95% CI 1.1 to 3.5), 1.3% (95% CI 0.2 to 2.4), 3.1% (95% CI 1.4 to 4.8) for the respective intervention phases. No impact on any of the indicators was observed when only the software technology part of the Command Centre was considered.Conclusion Implementation of a hospital Command Centre may have a marginal positive impact on patient safety when implemented as part of a broader hospital-wide improvement programme including colocation of operations and clinical leads in a central location. However, improvement in patient safety indicators was also observed for a comparable period in the control site. Further evaluative research into the impact of hospital command centres on a broader range of patient safety and other outcomes is warranted.https://informatics.bmj.com/content/30/1/e100653.full |
| spellingShingle | Rebecca Randell Ibrahim Habli Tom Lawton Jonathan Benn Teumzghi F Mebrahtu Carolyn McCrorie Ciarán D McInerney Josh Granger Naeem Sheikh Owen Ashby Johnson Effect of a hospital command centre on patient safety: an interrupted time series study BMJ Health & Care Informatics |
| title | Effect of a hospital command centre on patient safety: an interrupted time series study |
| title_full | Effect of a hospital command centre on patient safety: an interrupted time series study |
| title_fullStr | Effect of a hospital command centre on patient safety: an interrupted time series study |
| title_full_unstemmed | Effect of a hospital command centre on patient safety: an interrupted time series study |
| title_short | Effect of a hospital command centre on patient safety: an interrupted time series study |
| title_sort | effect of a hospital command centre on patient safety an interrupted time series study |
| url | https://informatics.bmj.com/content/30/1/e100653.full |
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