The Communicating Narrative Concerns Entered by Registered Nurses (CONCERN) Clinical Decision Support Early Warning...

Area of Science:

• Clinical Informatics
• Artificial Intelligence in Healthcare
• Patient Safety

Background:

• Hundreds of thousands of inpatients die annually from cardiac arrest and sepsis.
• Early detection of patient deterioration and timely interventions can prevent mortality.
• A system is needed to translate real-time patient data into actionable clinical information.

Purpose of the Study:

• To implement and evaluate the effectiveness and usability of the COmmunicating Narrative Concerns Entered by Registered Nurses (CONCERN) clinical decision support (CDS) system.
• To decrease negative health outcomes in hospitalized patients, including mortality, length of stay, cardiac arrest, ICU transfers, and readmission rates.
• To assess the CONCERN CDS system's impact in a cluster randomized pragmatic clinical trial across two study sites.

Main Methods:

• A 1-year multiple time-series intervention using a phased approach: pilot testing, optimized activation, and silent release.
• Implementation of the CONCERN CDS system, including user training.
• Mixed methods approach to assess the system and gather clinician perspectives.

Main Results:

• Data collection and analysis are expected to conclude by August 2022.
• Previous work suggests the CONCERN system is expected to positively impact mortality rates and length of stay.

Conclusions:

• The CONCERN CDS system is anticipated to enhance team-based situational awareness.
• It aims to foster a shared understanding of patients at risk for clinical deterioration.
• The system is designed to facilitate timely interventions, preventing mortality and associated harm.