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Frontiers of Information Technology & Electronic Engineering

ISSN 2095-9184 (print), ISSN 2095-9230 (online)

Design and implementation of a platform for configuring clinical dynamic safety checklist applications

Abstract: In recent years, it has been demonstrated that checklists can improve patient safety significantly. To facilitate the effective use of checklists in daily practice, both the medical community and the informatics community propose to implement checklists in dynamic checklist applications that can be integrated into the clinical workflow and that is specific to the patient context. However, it is difficult to develop such applications because they are tightly intertwined with the content of specific checklists. We propose a platform that enables access to dynamic checklist applications by configuring the infrastructures provided in the platform. Then, the applications can be developed without time-consuming programming work. We define a number of design criteria regarding point of care and clinical processes by analyzing the existing checklist applications and the lessons learned from implementations. Then, by applying rule-based clinical decision support and workflow management technologies, we design technical mechanisms to satisfy the design criteria. A dynamic checklist application platform is designed based on these mechanisms. Finally, we build a platform in various design cycle iterations, driven by multiple clinical cases. By applying the platform, we develop nine comprehensive dynamic checklist applications with 242 dynamic checklists. The results demonstrate both the feasibility and the overall generic nature of the proposed approach. We propose a novel platform for configuring dynamic checklist applications. This platform satisfies the general requirements and can be easily configured to satisfy different scenarios in which safety checklists are used.

Key words: Checklist, Workflow, Clinical decision support, Process management, Patient safety

Chinese Summary  <19> 一种临床动态安全清单系统配置平台的设计与实现

概要:近年来的研究日益表明,清单可显著改善病人安全。为促使清单在临床实践中有效使用,医学界和信息学界都建议把清单部署成动态清单系统,实现与临床信息系统的集成,动态适配病人上下文信息。然而,由于系统与特定内容的紧密耦合,开发这样的系统非常困难。提出一种临床安全清单系统动态配置平台,整合平台内部基础设施构建动态安全清单系统,避免用户为每个应用重复开发安全清单系统。分析现有清单系统功能和实施中的经验教训,定义了该平台的设计指标。然后整合基于规则的临床决策支持技术和工作流管理技术,设计了一套技术方案。基于该技术方案,设计开发了一套动态清单配置平台,并基于多个临床案例对其不断完善。通过应用该平台,开发了针对9个典型医疗流程的242个动态清单。结果表明,使用本文提出的方法实现临床动态安全清单系统的配置,具有可行性和通用性。

关键词组:清单;工作流;临床决策支持;过程管理;病人安全


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DOI:

10.1631/FITEE.1700623

CLC number:

C936

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On-line Access:

2018-09-04

Received:

2017-09-22

Revision Accepted:

2017-12-03

Crosschecked:

2018-07-12

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