Clinical trial NCT03757884: Medical Decisions in the Hospital Setting- M-Safety
Official title: Improving Medical-Decision Through Cognition, Technology and Communication, Phase 2
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Diagnostic Errors
Keywords: Diagnostic Errors
Hospital Medicine
Lead sponsor: University of Michigan
Sponsor class: OTHER
Collaborators: name: Agency for Healthcare Research and Quality (AHRQ)
First posted: 2018-11-29
Enrollment: 59
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Pre-posttest study design
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This project will introduce and evaluate an intervention designed to improve diagnostic decision making. The intervention will attempt to increase clinician mindfulness and reduce environmental distractions to promote focused thinking. A meta-cognitive intervention using a structured checklist will be evaluated to identify improvement in diagnostic and therapeutic decision-making and examine the role of mindfulness and architectural design in enhancing patient safety.

Detailed description: This project will introduce and evaluate an intervention designed to improve diagnostic decision making. The intervention will attempt to increase clinician mindfulness and reduce environmental distractions to promote system 2 thinking. A meta-cognitive intervention using a structured checklist will be evaluated to identify improvement in diagnostic and therapeutic decision-making and examine the role of mindfulness and architectural design in enhancing patient safety.

This a pretest-posttest design study that will be conducted with hospitalist physicians working at Michigan Medicine and/or the VA Ann Arbor Healthcare System. The proposed intervention will provide the participants with tools to help promote mindfulness and focus to assist with the diagnostic process. To reduce distraction, headphones to block out surrounding noise and table screens to limit distractions will be offered. To assist with diagnosis, a diagnostic checklist and use of a IPad to use an online diagnosis application will be provided.

Eligibility criteria: Inclusion Criteria:

* Hospital Medicine Physicians

Exclusion Criteria:

* Physicians other than Hopitalists

Primary outcomes:
measure: Change in Number of Patient Differential Diagnosis
timeFrame: 8 months
measure: Change in the Use of Diagnostic Checklist
timeFrame: 8 months
Secondary outcomes:
measure: Change in Mindfulness Behaviors Score
timeFrame: 8 months
measure: Change in Number of Patient Diagnostic Testing
timeFrame: 8 months
measure: Change in Time Participants are Measured as Calm
timeFrame: 8 months
measure: Change in Time Participants are Measured as Focused
timeFrame: 8 months
measure: Change in Time Participants are Measured as Tense
timeFrame: 8 months
Other outcomes:
Locations:
city: Ann Arbor
country: United States
facility: Ann Arbor VA Healthcare System
state: Michigan
city: Ann Arbor
country: United States
facility: University of Michigan
state: Michigan
Study officials:
affiliation: University of Michigan
name: Vineet I Chopra, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Chopra V, Harrod M, Winter S, Forman J, Quinn M, Krein S, Fowler KE, Singh H, Saint S. Focused Ethnography of Diagnosis in Academic Medical Centers. J Hosp Med. 2018 Oct 1;13(10):668-672. doi: 10.12788/jhm.2966. Epub 2018 Apr 25.