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dc.contributor.authorWard, Marie
dc.contributor.authorMcAuliffe, Eilish
dc.contributor.authorWakai, Abel
dc.contributor.authorGeary, Una
dc.contributor.authorBrowne, John
dc.contributor.authorDeasy, Conor
dc.contributor.authorSchull, Michael
dc.contributor.authorBoland, Fiona
dc.contributor.authorMcDaid, Fiona
dc.contributor.authorCoughlan, Eoin
dc.contributor.authorO’Sullivan, Ronan
dc.date.accessioned2017-01-25T11:47:26Z
dc.date.available2017-01-25T11:47:26Z
dc.date.issued2017-01-23
dc.identifier.citationBMC Health Services Research. 2017 Jan 23;17(1):67en
dc.identifier.urihttp://dx.doi.org/10.1186/s12913-017-2014-9
dc.identifier.urihttp://hdl.handle.net/10147/621032
dc.description.abstractAbstract Background Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED). Methods A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of ‘Plan Do Study Act’ (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed. Discussion Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration.
dc.language.isoenen
dc.subjectEMERGENCY MEDICAL CAREen
dc.subjectHOSPITALSen
dc.subjectPATIENT SAFETYen
dc.subjectMONITORINGen
dc.titleStudy protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approachen
dc.language.rfc3066en
dc.rights.holderThe Author(s).
dc.date.updated2017-01-23T17:03:03Z
refterms.dateFOA2018-08-27T18:42:00Z
html.description.abstractAbstract Background Early detection of patient deterioration is a key element of patient safety as it allows timely clinical intervention and potential rescue, thus reducing the risks of serious patient safety incidents. Longitudinal patient monitoring systems have been widely recommended for use to detect clinical deterioration. However, there is conflicting evidence on whether they improve patient outcomes. This may in part be related to variation in the rigour with which they are implemented and evaluated. This study aims to evaluate the implementation and effectiveness of a longitudinal patient monitoring system designed for adult patients in the unique environment of the Emergency Department (ED). Methods A novel participatory action research (PAR) approach is taken where socio-technical systems (STS) theory and analysis informs the implementation through the improvement methodology of ‘Plan Do Study Act’ (PDSA) cycles. We hypothesise that conducting an STS analysis of the ED before beginning the PDSA cycles will provide for a much richer understanding of the current situation and possible challenges to implementing the ED-specific longitudinal patient monitoring system. This methodology will enable both a process and an outcome evaluation of implementing the ED-specific longitudinal patient monitoring system. Process evaluations can help distinguish between interventions that have inherent faults and those that are badly executed. Discussion Over 1.2 million patients attend EDs annually in Ireland; the successful implementation of an ED-specific longitudinal patient monitoring system has the potential to affect the care of a significant number of such patients. To the best of our knowledge, this is the first study combining PAR, STS and multiple PDSA cycles to evaluate the implementation of an ED-specific longitudinal patient monitoring system and to determine (through process and outcome evaluation) whether this system can significantly improve patient outcomes by early detection and appropriate intervention for patients at risk of clinical deterioration.


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