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.