Effectiveness of SIESTA on Objective and Subjective Metrics of Nighttime Hospital Sleep Disruptors

Arora, Vineet M.; Machado, Nolan; Anderson, Samantha; Desai, Nimit; Marsack, William; Blossomgame, Stephenie; Tuvilleja, Ambrosio; Ramos, Jacqueline; Francisco, Mary Ann; LaFond, Cynthia M.; Leung, Edward Ki Yun; Valencia, A Wilson; Martin, Shannon; Meltzer, David O.; Farnan, Jeanne M.; Balachandran, Jay S.; Knutson, Kristen L.; Mokhlesi, Babak

doi:10.12788/jhm.3091

Cited by 42 publications

(37 citation statements)

References 19 publications

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“…This experience with a simple EHR-based change aligns with a growing body of work utilizing the concept of electronic “nudges” to improve patient care. 11-13…”

Section: Discussionmentioning

confidence: 99%

Using Safety Barrier Analysis to Facilitate Quality Improvement in Health Care: Improving Venous Thromboembolism Prophylaxis as a Proof of Concept

et al. 2019

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Effective quality improvement is a key factor in optimizing the care of hospitalized patients. Unfortunately, the US health care system has a poor safety record when compared to other major industries. For example, at 250 000 per year, medical errors are the third leading cause of death in the United States. Safety barrier management, a widely used methodology in high-risk industries such as commercial airline transportation and oil drilling, has not been widely used in traditional quality improvement efforts in health care, which rely more on standard lean Six Sigma quality approaches. The authors describe a quality improvement project that uses safety barrier analysis to help inform solutions to improve venous thromboembolism prophylaxis in hospitalized patients. This study found that safety barrier analysis helped inform solutions to improve venous thromboembolism prophylaxis at the study institution and can be a useful adjunct to standard lean Six Sigma methodologies for quality improvement in health care.

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“…This experience with a simple EHR-based change aligns with a growing body of work utilizing the concept of electronic “nudges” to improve patient care. 11-13…”

Section: Discussionmentioning

confidence: 99%

Using Safety Barrier Analysis to Facilitate Quality Improvement in Health Care: Improving Venous Thromboembolism Prophylaxis as a Proof of Concept

et al. 2019

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“…To date, much of the research on sleep promotion has been conducted among non-hospitalized populations [ 6 – 10 ]. Meanwhile, the limited amount of research directed at improving sleep in the hospital has focused on staff interventions [ 7 – 9 ] rather than patient empowerment. In other arenas, higher patient activation and empowerment have been associated with numerous positive outcomes, including fewer unmet medical needs, increased treatment adherence, improved care experiences, and better health outcomes [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Piloting I-SLEEP: a patient-centered education and empowerment intervention to improve patients’ in-hospital sleep

Mason

Orlov

Anderson

et al. 2021

Pilot Feasibility Stud

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Background Sleep disturbances in hospitalized patients are linked to poor recovery. In preparation for a future randomized controlled trial, this pilot study evaluated the feasibility and acceptability of a multi-component intervention (I-SLEEP) that educates and empowers inpatients to advocate for fewer nighttime disruptions in order to improve sleep during periods of hospitalization. Methods Eligible inpatients received I-SLEEP, which included an educational video, brochure, sleep kit, and three questions patients can ask their team to reduce nighttime disruptions. Following I-SLEEP, inpatients were surveyed on the primary feasibility outcomes of satisfaction with and use of I-SLEEP components. Inpatients were also surveyed regarding empowerment and understanding of intervention materials. Patient charts were reviewed to collect data on nighttime (11 PM–7 AM) vital sign and blood draws disruptions. Results Ninety percent (n = 26/29) of patients were satisfied with the brochure and 87% (n = 27/31) with the video. Nearly all (95%, n = 36/37) patients felt empowered to ask their providers to minimize nighttime disruptions and 68% (n = 26/37) intended to alter sleep habits post-discharge. Forty-nine percent (n = 18/37) of patients asked an I-SLEEP question. Patients who asked an I-SLEEP question were significantly more likely to experience nights with fewer disruptions due to nighttime vitals (19% vs. 2.1%, p = 0.008). Conclusion This pilot study found that I-SLEEP was well-accepted and enabled hospitalized patients to advocate for less disrupted sleep. Educating patients to advocate for reducing nighttime disruptions may be a patient-centered, low-cost strategy to improve patients’ care and in-hospital experience. These results suggest that I-SLEEP is ready to be evaluated against routine care in a future randomized controlled trial. Trial registration ClinicalTrials.Gov NCT04151251.

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“…We believe both factors likely were necessary, with reminders serving as low-intensity nudges suggesting but not forcing a course of action. 2 Correlation with the number of safety events was not investigated.…”

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confidence: 99%

Q-Tip: Implementation of a Text-Based, HIPAA-Compliant Event Reporting Process to Increase Event Reporting by Resident Physicians

et al. 2020

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Resident physicians participate in voluntary safety event reporting less than other health care professionals, despite witnessing safety events. 1 During the 2018 Clinical Learning Environment Review at Thomas Jefferson University Hospital, 74% of residents surveyed reported experiencing a safety event, while only 33% reported submitting an event report. In the first quarter of fiscal year 2019, residents at the institution reported 37 of 1999 events (1.8%). The usability of the institutional reporting platform has been identified locally as a barrier. The project team investigated the use of a HIPAAcompliant mobile application already used for clinical communication as an alternative reporting platform for residents. The goal was to increase resident reporting from a historical average of 1.5 events per week to an average 3 events per week during a 10-week pilot. Residents reported events via the secure mobile application. Events were then entered by members of the study group into the reporting system for institutional review. Process changes occurred weekly following interval data review and stakeholder interviews. During the first 2 weeks, 6 residents received education on and access to the platform. No events were reported, and residents stated that they forgot that the account existed when engaged in clinical work. In subsequent weeks, daily reminders were sent to participating residents directly from the reporting account, and supervising attendings were encouraged to identify events for submission with their teams. Eighty-six of 892 total residents were ultimately permitted access to the account. In subsequent improvement cycles, a standardized reply to reporters was composed that requested basic information necessary for event entry. This change improved the workflow for study group members, reducing the need for extensive chart review. Reporting increased throughout the 10-week pilot. In total, 28 events were submitted via mobile application,

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Effectiveness of SIESTA on Objective and Subjective Metrics of Nighttime Hospital Sleep Disruptors

Cited by 42 publications

References 19 publications

Using Safety Barrier Analysis to Facilitate Quality Improvement in Health Care: Improving Venous Thromboembolism Prophylaxis as a Proof of Concept

Using Safety Barrier Analysis to Facilitate Quality Improvement in Health Care: Improving Venous Thromboembolism Prophylaxis as a Proof of Concept

Piloting I-SLEEP: a patient-centered education and empowerment intervention to improve patients’ in-hospital sleep

Q-Tip: Implementation of a Text-Based, HIPAA-Compliant Event Reporting Process to Increase Event Reporting by Resident Physicians

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