Effect of a hospital command centre on patient safety: an interrupted time series study

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Publication date
2023-01Author
Mebrahtu, T.F.McInerney, C.D.
Benn, J.
McCrorie, C.
Granger, J.
Lawton, T.
Sheikh, N.
Randell, Rebecca

Habli, I.
Johnson, O.A.
Rights
© 2023 Author(s) (or their employer(s)). This is an Open Access article distributed under the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)Peer-Reviewed
YesOpen Access status
openAccessAccepted for publication
2022-12-19
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Show full item recordAbstract
Command centres have been piloted in some hospitals across the developed world in the last few years. Their impact on patient safety, however, has not been systematically studied. Hence, we aimed to investigate this. This is a retrospective population-based cohort study. Participants were patients who visited Bradford Royal Infirmary Hospital and Calderdale & Huddersfield hospitals between 1 January 2018 and 31 August 2021. A five-phase, interrupted time series, linear regression analysis was used. After introduction of a Command Centre, while mortality and readmissions marginally improved, there was no statistically significant impact on postoperative sepsis. In the intervention hospital, when compared with the preintervention period, mortality decreased by 1.4% (95% CI 0.8% to 1.9%), 1.5% (95% CI 0.9% to 2.1%), 1.3% (95% CI 0.7% to 1.8%) and 2.5% (95% CI 1.7% to 3.4%) during successive phases of the command centre programme, including roll-in and activation of the technology and preparatory quality improvement work. However, in the control site, compared with the baseline, the weekly mortality also decreased by 2.0% (95% CI 0.9 to 3.1), 2.3% (95% CI 1.1 to 3.5), 1.3% (95% CI 0.2 to 2.4), 3.1% (95% CI 1.4 to 4.8) for the respective intervention phases. No impact on any of the indicators was observed when only the software technology part of the Command Centre was considered. Implementation of a hospital Command Centre may have a marginal positive impact on patient safety when implemented as part of a broader hospital-wide improvement programme including colocation of operations and clinical leads in a central location. However, improvement in patient safety indicators was also observed for a comparable period in the control site. Further evaluative research into the impact of hospital command centres on a broader range of patient safety and other outcomes is warranted.Version
Published versionCitation
Mebrahtu TF, McInerney CD, Benn J et al (2023) Effect of a hospital command centre on patient safety: an interrupted time series study. BMJ Health & Care Informatics. 30(1): e100653.Link to Version of Record
https://doi.org/10.1136/bmjhci-2022-100653Type
Articleae974a485f413a2113503eed53cd6c53
https://doi.org/10.1136/bmjhci-2022-100653