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Shared-Task Worklists Improve Clinical Trial Recruitment Workflow in an Academic Emergency Department
Authors:Kevin S Naceanceno  Stacey L House  Phillip V Asaro
Affiliation:1.Washington University School of Medicine, St. Louis, Missouri, United States;2.Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri, United States
Abstract:Background  Clinical trials performed in our emergency department at Barnes-Jewish Hospital utilize a centralized infrastructure for alerting, screening, and enrollment with rule-based alerts sent to clinical research coordinators. Previously, all alerts were delivered as text messages via dedicated cellular phones. As the number of ongoing clinical trials increased, the volume of alerts grew to an unmanageable level. Therefore, we have changed our primary notification delivery method to study-specific, shared-task worklists integrated with our pre-existing web-based screening documentation system. Objective  To evaluate the effects on screening and recruitment workflow of replacing text-message delivery of clinical trial alerts with study-specific shared-task worklists in a high-volume academic emergency department supporting multiple concurrent clinical trials. Methods  We analyzed retrospective data on alerting, screening, and enrollment for 10 active clinical trials pre- and postimplementation of shared-task worklists. Results  Notifications signaling the presence of potentially eligible subjects for clinical trials were more likely to result in a screen ( p  < 0.001) with the implementation of shared-task worklists compared with notifications delivered as text messages for 8/10 clinical trials. The change in workflow did not alter the likelihood of a notification resulting in an enrollment ( p  = 0.473). The Director of Research reported a substantial reduction in the amount of time spent redirecting clinical research coordinator screening activities. Conclusion  Shared-task worklists, with the functionalities we have described, offer a viable alternative to delivery of clinical trial alerts via text message directly to clinical research coordinators recruiting for multiple concurrent clinical trials in a high-volume academic emergency department.
Keywords:alert fatigue  electronic health records  emergency department  clinical trials  workflow  clinical trial alerts  clinical trial recruitment
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