Intelligent checklists improve checklist compliance in the intensive care unit: a prospective before-and-after mixed-method study.

British Journal of Anaesthesia
A J R De BieErik H H M Korsten

Abstract

We examined whether a context and process-sensitive 'intelligent' checklist increases compliance with best practice compared with a paper checklist during intensive care ward rounds. We conducted a single-centre prospective before-and-after mixed-method trial in a 35 bed medical and surgical ICU. Daily ICU ward rounds were observed during two periods of 8 weeks. We compared paper checklists (control) with a dynamic (digital) clinical checklist (DCC, intervention). The primary outcome was compliance with best clinical practice, measured as the percentages of checked items and unchecked critical items. Secondary outcomes included ICU stay and the usability of digital checklists. Data are presented as median (interquartile range). Clinical characteristics and severity of critical illness were similar during both control and intervention periods of study. A total of 36 clinicians visited 197 patients during 352 ward rounds using the paper checklist, compared with 211 patients during 366 ward rounds using the DCC. Per ICU round, a median of 100% of items (94.4-100.0) were completed by DCC, compared with 75.1% (66.7-86.4) by paper checklist (P=0.03). No critical items remained unchecked by the DCC, compared with 15.4% (8.3-27.3) by t...Continue Reading

Associated Clinical Trials

References

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Sep 1, 2017·British Journal of Anaesthesia·A J R De BieH H M Korsten
Dec 14, 2017·BMC Medical Informatics and Decision Making·Shan NanHuilong Duan
Mar 25, 2018·BMJ Quality & Safety·Bethany Danae HallamJeremy M Kahn
Apr 29, 2018·International Journal of Emergency Medicine·Ronaldo Sevilla-BerriosOgnjen Gajic

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Citations

Feb 6, 2021·British Journal of Anaesthesia·Jennifer M Weller, Craig S Webster

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