How can artificial intelligence decrease cognitive and work burden for front line practitioners?

Artificial intelligence (AI) has tremendous potential to improve the cognitive and work burden of clinicians across a range of clinical activities, which could lead to reduced burnout and better clinical care. The recent explosion of generative AI nicely illustrates this potential. Developers and organizations deploying AI have a responsibility to ensure AI is designed and implemented with end-user input, has mechanisms to identify and potentially reduce bias, and that the impact on cognitive and work burden is measured, monitored, and improved.

The impact of health information technology on patient safety.

Since the original Institute of Medicine (IOM) report was published there has been an accelerated development and adoption of health information technology with varying degrees of evidence about the impact of health information technology on patient safety.  This article is intended to review the current available scientific evidence on the impact of different health information technologies on improving patient safety outcomes. We conclude that health information technology improves patient's safety by reducing medication errors, reducing adverse drug reactions, and improving compliance to practice guidelines.

Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project.

Objective: Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas.

Study Setting: In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts.

Study Design: Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting "3+1" high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools.

Involvement of health-care professionals in an adverse event: the role of management in supporting their workforce.

Introduction:  After an adverse event, not only patients and family members but also health-care professionals involved in the event become victims. More than 50% of all health-care professionals suffer emotionally and professionally after being involved in an adverse event. Support is needed for these "second victims" to prevent a further negative impact on patient care.

Developing a pathway for high-value, patient-centered total joint arthroplasty.

Background: Total joint arthroplasty (TJA) is one of the most widely performed elective procedures; however, there are wide variations in cost and quality among facilities where the procedure is performed.

Questions/purposes: The purposes of this study were to (1) develop a generalizable clinical care pathway for primary TJA using inputs from clinical, academic, and patient stakeholders; and (2) identify system- and patient-level processes to provide safe, effective, efficient, and patient-centered care for patients undergoing TJA.

Methods: We used a combination of quantitative and qualitative methods to design a care pathway that spans 14 months beginning with the presurgical office visit and concluding 12 months after discharge.

'Global trigger tool' shows that adverse events in hospitals may be ten times greater than previously measured.

Identification and measurement of adverse medical events is central to patient safety, forming a foundation for accountability, prioritizing problems to work on, generating ideas for safer care, and testing which interventions work. We compared three methods to detect adverse events in hospitalized patients, using the same patient sample set from three leading hospitals. We found that the adverse event detection methods commonly used to track patient safety in the United States today-voluntary reporting and the Agency for Healthcare Research and Quality's Patient Safety Indicators-fared very poorly compared to other methods and missed 90 percent of the adverse events.

Bar coding: what's your role?

As many as 32% of medication errors occur during administration, so there's good reason to find effective methods to minimize these error opportunities.

Safely automating the medication use process. Not as easy as it looks.

The medication use process is one of the most complex and risky clinical care processes in the hospital. It involves a large number of caregivers in widely diverse areas: physicians, nurses, pharmacists and respiratory therapists. Studies performed over the past several years have shown that medication errors and adverse events occur in all parts of the medication use process.

An intervention to decrease narcotic-related adverse drug events in children's hospitals.

Objectives: Narcotic-related adverse drug events are the most common adverse drug events in hospitalized children. Despite multiple published studies describing interventions that decrease adverse drug events from narcotics, large-scale collaborative quality improvement efforts to address narcotic-related adverse drug events in pediatrics have not been described. The purpose of this study was to evaluate collaborative-wide narcotic-related adverse drug event rates after a collection of expert panel-defined best practices was implemented.

Preventing harm from high-alert medications.

Background: One of the 12 interventions that the Institute for Healthcare Improvement (IHI) recommends for its 5 Million Lives Campaign is "Prevent Harm from High-Alert Medications . . .

Reconciling medications at admission: safe practice recommendations and implementation strategies.

Background: Fifty hospitals collaborated in a patient safety initiative developed and implemented by the Massachusetts Coalition for the Prevention of Medical Errors and the Massachusetts Hospital Association.

Methods: A consensus group identified safe practices and suggested implementation strategies. Four collaborative learning sessions were offered, and teams monitored their progress and shared successful strategies and lessons learned.

Adverse drug events in ambulatory care.

Background: Adverse events related to drugs occur frequently among inpatients, and many of these events are preventable. However, few data are available on adverse drug events among outpatients. We conducted a study to determine the rates, types, severity, and preventability of such events among outpatients and to identify preventive strategies.

Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients.

Objectives: Medication errors in pediatric inpatients occur at similar rates as in adults but have 3 times the potential to cause harm. Error prevention strategies in this setting remain largely untested. The objective of this study was to classify the major types of medication errors in pediatric inpatients and to determine which strategies might most effectively prevent them.

Analysis of medication-related malpractice claims: causes, preventability, and costs.

Background: Adverse drug events (ADEs) may lead to serious injury and may result in malpractice claims. While ADEs resulting in claims are not representative of all ADEs, such data provide a useful resource for studying ADEs. Therefore, we conducted a review of medication-related malpractice claims to study their frequency, nature, and costs and to assess the human factor failures associated with preventable ADEs.