ASCENT — IgNITE Lab

In outpatient health care settings like physicians’ offices, there are significant risks to patients’ safety, including delays in diagnosis and treatment which result in disease progression, preventable complications of treatment, and adverse drug events. Few systems exist to recognize and ameliorate such patient safety problems, and the overall aim is to design, develop, test, and evaluate innovative solutions to improve patient safety.

Main findings:

Implementation science is a valuable approach to respond to the constraints of a health care environment. We began our investigation asking ourselves, “how can the co-design of health information technology interventions influence uptake?” However, we found that the unique context of health care delivery plays a major role in uptake, and other implementation outcomes, across settings serving diverse patients. We learned that workflow analysis and journey mapping with front line staff can help reduce implementation challenges and improve the sustainability of an intervention.
There is limited epidemiological data on the extent of safety gaps, particularly in safety-net settings that struggle with fragmented record keeping systems. We sought to address ambulatory safety issues, such as delayed and missed monitoring of sub-critical test results. Many of the concerns that clinicians said kept them up at night - such as incomplete follow-up of incidental pulmonary nodules - lack data describing the extent of the problem. Therefore, we needed to invest in studying the epidemiology behind these safety gaps to better understand the impact of delayed and missed monitoring on patient outcomes.

Publications