Fundamental of Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Brazil.
Eldorado Research Institute, Campinas, Brazil.
JMIR Res Protoc. 2024 Aug 12;13:e55466. doi: 10.2196/55466.
The use of technologies has had a significant impact on patient safety and the quality of care and has increased globally. In the literature, it has been reported that people die annually due to adverse events (AEs), and various methods exist for investigating and measuring AEs. However, some methods have a limited scope, data extraction, and the need for data standardization. In Brazil, there are few studies on the application of trigger tools, and this study is the first to create automated triggers in ambulatory care.
This study aims to develop a machine learning (ML)-based automated trigger for outpatient health care settings in Brazil.
A mixed methods research will be conducted within a design thinking framework and the principles will be applied in creating the automated triggers, following the stages of (1) empathize and define the problem, involving observations and inquiries to comprehend both the user and the challenge at hand; (2) ideation, where various solutions to the problem are generated; (3) prototyping, involving the construction of a minimal representation of the best solutions; (4) testing, where user feedback is obtained to refine the solution; and (5) implementation, where the refined solution is tested, changes are assessed, and scaling is considered. Furthermore, ML methods will be adopted to develop automated triggers, tailored to the local context in collaboration with an expert in the field.
This protocol describes a research study in its preliminary stages, prior to any data gathering and analysis. The study was approved by the members of the organizations within the institution in January 2024 and by the ethics board of the University of São Paulo and the institution where the study will take place. in May 2024. As of June 2024, stage 1 commenced with data gathering for qualitative research. A separate paper focused on explaining the method of ML will be considered after the outcomes of stages 1 and 2 in this study.
After the development of automated triggers in the outpatient setting, it will be possible to prevent and identify potential risks of AEs more promptly, providing valuable information. This technological innovation not only promotes advances in clinical practice but also contributes to the dissemination of techniques and knowledge related to patient safety. Additionally, health care professionals can adopt evidence-based preventive measures, reducing costs associated with AEs and hospital readmissions, enhancing productivity in outpatient care, and contributing to the safety, quality, and effectiveness of care provided. Additionally, in the future, if the outcome is successful, there is the potential to apply it in all units, as planned by the institutional organization.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/55466.
技术的使用对患者安全和医疗质量产生了重大影响,并在全球范围内得到了广泛应用。在文献中,有报道称每年都有人因不良事件(AE)而死亡,并且存在各种调查和测量 AE 的方法。然而,一些方法的范围有限,数据提取和数据标准化的需求。在巴西,关于触发工具应用的研究较少,本研究首次在门诊护理中创建了自动化触发工具。
本研究旨在为巴西的门诊医疗保健环境开发基于机器学习(ML)的自动化触发工具。
将在设计思维框架内进行混合方法研究,并将原则应用于创建自动化触发工具,遵循以下阶段:(1)同理心和定义问题,包括观察和调查,以理解用户和手头的挑战;(2)构思,生成各种问题解决方案;(3)原型制作,构建最佳解决方案的最小表示;(4)测试,获取用户反馈以完善解决方案;(5)实施,测试经过完善的解决方案,评估更改并考虑扩展。此外,将采用 ML 方法来开发自动化触发工具,并与该领域的专家合作,针对当地情况进行定制。
本方案描述了一项初步研究,在进行任何数据收集和分析之前。该研究于 2024 年 1 月获得机构内组织成员的批准,并于 2024 年 5 月获得圣保罗大学和研究所在职伦理委员会的批准。截至 2024 年 6 月,第 1 阶段开始进行定性研究的数据收集。在本研究的第 1 阶段和第 2 阶段的结果之后,将考虑单独的一篇论文来解释 ML 方法。
在开发门诊环境中的自动化触发工具之后,更迅速地预防和识别潜在的 AE 风险,并提供有价值的信息。这项技术创新不仅促进了临床实践的进步,还有助于传播与患者安全相关的技术和知识。此外,医疗保健专业人员可以采用基于证据的预防措施,降低与 AE 和医院再入院相关的成本,提高门诊护理的生产力,并为提供的护理的安全性、质量和效果做出贡献。此外,如果结果成功,未来有可能按照机构组织的计划将其应用于所有单位。
国际注册报告标识符(IRRID):PRR1-10.2196/55466。