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Nurse-Led Ambient AI Scribe for Patient Safety Incident Investigation Reports (Project NARRATE): Retrospective
Kai Yunn Teo1, Liwen Huang1, Kelly Chai Yuen Woh1
1Department of Nursing Administration, Singapore General Hospital, Outram Road, Singapore, Singapore, 169608, Singapore, 65 63265843.
JMIR Nursing
|August 10, 2026
Summary
Project NARRATE, an AI-enhanced reporting system, significantly improved the completeness and quality of patient safety reports compared to conventional methods. This nursing-led workflow supports structured supervisor reporting for better organizational learning.
Area of Science:
- Healthcare Informatics
- Artificial Intelligence in Medicine
- Patient Safety
Background:
- Conventional free-text patient safety reports often lack completeness and detail, hindering organizational learning.
- Project NARRATE (Nursing AI-Refined for Accurate Transcription of Events) is a nursing-led ambient AI workflow designed to improve report quality.
- NARRATE utilizes prompts aligned with WHO standards and visible missing-information cues to guide structured reporting.
Purpose of the Study:
- To compare the completeness and narrative quality of supervisor investigation reports generated through conventional methods versus the NARRATE system.
- The study focused on incidents related to patient falls and medication administration.
Main Methods:
- A retrospective pre-post document-quality study was conducted at a tertiary academic medical center.
- 150 deidentified supervisor investigation reports were reviewed (75 conventional, 75 NARRATE).
- Reports were assessed using a WHO-aligned completeness checklist and an adapted Physician Documentation Quality Instrument (PDQI) by blinded reviewers.
Main Results:
- NARRATE reports demonstrated significantly higher WHO total completeness (adjusted mean difference 1.95 points, P<.001) and adapted PDQI scores (adjusted mean difference 0.53 points, P<.001) compared to conventional reports.
- A sensitivity analysis confirmed the completeness and quality advantage of NARRATE reports even when deformatted.
- Specific domains like explanation, organization, and comprehensibility were significantly higher in NARRATE reports.
Conclusions:
- Voluntary adoption of the NARRATE system was associated with more complete and higher-quality patient safety reports.
- The findings support the structured workflow of NARRATE, not individual AI components.
- Further evaluation is needed under broader adoption to confirm downstream patient safety effects.