Intelligent checklists improve checklist compliance in the intensive care unit: a prospective before-and-after mixed-method study

BackgroundWe examined whether a context and process-sensitive ‘intelligent’ checklist increases compliance with best practice compared paper during intensive care ward rounds.MethodsWe conducted single-centre prospective before-and-after mixed-method trial in 35 bed medical surgical ICU. Daily ICU rounds were observed two periods of 8 weeks. We checklists (control) dynamic (digital) clinical (DCC, intervention). The primary outcome was practice, measured as the percentages checked items unchecked critical items. Secondary outcomes included stay usability digital checklists. Data are presented median (interquartile range).ResultsClinical characteristics severity illness similar both control intervention study. A total 36 clinicians visited 197 patients 352 using checklist, 211 366 DCC. Per round, 100% (94.4–100.0) completed by DCC, 75.1% (66.7–86.4) (P=0.03). No remained 15.4% (8.3–27.3) (P=0.01). DCC associated reduced (1 day [1–3]), (2 days [1–4]; P=0.05). Usability judged to require further improvement.ConclusionsA improved on mixed ICU.Clinical registrationNCT 03599856.