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. 2023 Nov 13;23(1):1245.
doi: 10.1186/s12913-023-10255-7.

"The project did not come to us with a solution": Perspectives of research teams on implementing a study about electronic health record-embedded individualized pain plans for emergency department treatment of vaso-occlusive episodes in adults with sickle cell disease

Ana A Baumann  1 , Jane S Hankins  2   3 , Lewis L Hsu  4 , Robert W Gibson  5 , Lynne D Richardson  6 , Marsha Treadwell  7 , Jeffrey A Glassberg  8 , Sarah Bourne  9 , Lingzi Luo  10 , Rita V Masese  11 , Terri Demartino  11 , Judith Nocek  4 , Elizabeth Taaffe  12 , Sierra Gollan  5 , Ome-Ollin Ruiz  7 , Chinonyelum Nwosu  2   13 , Nai Qashou  12 , Aimee S James  14 , Paula Tanabe  11 , Allison A King  14   12
Affiliations

"The project did not come to us with a solution": Perspectives of research teams on implementing a study about electronic health record-embedded individualized pain plans for emergency department treatment of vaso-occlusive episodes in adults with sickle cell disease

Ana A Baumann et al. BMC Health Serv Res. .

Abstract

Background: This study aimed to capture the implementation process of the ALIGN Study, (An individualized Pain Plan with Patient and Provider Access for Emergency Department care of Sickle Cell Disease). ALIGN aimed to embed Individualized Pain Plans in the electronic health record (E-IPP) and provide access to the plan for both adult patients with sickle cell disease (SCD) and emergency department providers when a person with SCD comes to the emergency department in vaso-occlusive crises.

Methods: Semi-structured interviews were conducted with research teams from the 8 participating sites from the ALIGN study. Seventeen participants (principal investigators and study coordinators) shared their perspectives about the implementation of ALIGN in their sites. Data were analyzed in three phases using open coding steps adapted from grounded theory and qualitative content analysis.

Results: A total of seven overarching themes were identified: (1) the E-IPP structure (location and upkeep) and collaboration with the informatics team, (2) the role of ED champion, (3) the role of research coordinators, (4) research team communication, and communication between research team and clinical team, (5) challenges with the study protocol, (6) provider feedback: addressing over-utilizers, patient mistrust, and the positive feedback about the intervention, and (7) COVID-19 and its effects on study implementation.

Conclusions: Findings from this study contribute to learning how to implement E-IPPs for adult patients with SCD in ED. The study findings highlight the importance of early engagement with different team members, a champion from the emergency department, study coordinators with different skills and enhancement of communication and trust among team members. Further recommendations are outlined for hospitals aiming to implement E-IPP for patients with SCD in ED.

Keywords: Emergency department; Implementation science; Sickle cell disease.

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Conflict of interest statement

PT is a consultant for CSL Behring. The other authors report no competing interest.

Figures

Fig. 1
Fig. 1
SCDIC Align Study Overview
See this image and copyright information in PMC

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