Study protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approach

Show simple item record

dc.contributor.author Ward, Marie
dc.contributor.author McAuliffe, Eilish
dc.contributor.author Wakai, Abel
dc.contributor.author Geary, Una
dc.contributor.author Browne, John P.
dc.contributor.author Deasy, Conor
dc.contributor.author Schull, Michael
dc.contributor.author Boland, Fiona
dc.contributor.author McDaid, Fiona
dc.contributor.author Couglan, Eoin
dc.contributor.author O'Sullivan, Ronan
dc.date.accessioned 2017-01-30T15:36:31Z
dc.date.available 2017-01-30T15:36:31Z
dc.date.issued 2017-01-23
dc.identifier.citation Ward, M., McAuliffe, E., Wakai, A., Geary, U., Browne, J., Deasy, C., Schull, M., Boland, F., McDaid, F., Coughlan, E. and O’Sullivan, R. (2017) 'Study protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approach', BMC Health Services Research, 17(1), pp. 67. doi:10.1186/s12913-017-2014-9 en
dc.identifier.volume 17 en
dc.identifier.startpage 67-1 en
dc.identifier.endpage 67-10 en
dc.identifier.issn 1472-6963
dc.identifier.uri http://hdl.handle.net/10468/3539
dc.identifier.doi 10.1186/s12913-017-2014-9
dc.description.abstract 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. en
dc.description.sponsorship Health Research Board, the Health Service Executive and the Royal College of Physicians, Ireland (Research Collaborative in Quality and Patient Safety (RCQPS) Awards) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central en
dc.rights © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Longitudinal patient monitoring en
dc.subject Early warning score en
dc.subject Emergency department en
dc.subject Socio-technical systems en
dc.subject Participatory AR Process and outcome evaluation en
dc.title Study protocol for evaluating the implementation and effectiveness of an emergency department longitudinal patient monitoring system using a mixed-methods approach en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother John Browne, Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: J.Browne@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Research Board en
dc.contributor.funder Health Service Executive, Ireland en
dc.contributor.funder Royal College of Physicians, Ireland en
dc.contributor.funder Royal College of Physicians, Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Health Services Research en
dc.internal.IRISemailaddress j.browne@ucc.ie en


Files in this item

This item appears in the following Collection(s)

Show simple item record

© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
This website uses cookies. By using this website, you consent to the use of cookies in accordance with the UCC Privacy and Cookies Statement. For more information about cookies and how you can disable them, visit our Privacy and Cookies statement