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Clinical Reminders Designed and Implemented Using Cognitive and Organizational Science Principles Decrease Reminder Fatigue.

Overview of attention for article published in Journal of the American Board of Family Medicine (formerly Journal of the American Board of Family Practice), May 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (90th percentile)
  • Good Attention Score compared to outputs of the same age and source (66th percentile)

Mentioned by

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25 tweeters
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1 Facebook page

Readers on

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25 Mendeley
Title
Clinical Reminders Designed and Implemented Using Cognitive and Organizational Science Principles Decrease Reminder Fatigue.
Published in
Journal of the American Board of Family Medicine (formerly Journal of the American Board of Family Practice), May 2015
DOI 10.3122/jabfm.2015.03.140243
Pubmed ID
Authors

Lee A. Green, Donald Nease, Michael S. Klinkman

Abstract

Response rates to point-of-care clinical reminders typically decrease over time. We hypothesized that this "reminder fatigue" could be prevented by (1) applying sound human factors engineering and cognitive science principles in designing the reminder system, and (2) implementing the reminders with rigorous attention to organizational science principles. This was a retrospective cohort enumeration from January 1, 2006, through July 31, 2012, in a set of 5 academically affiliated family medicine practices. We modeled the odds ratio of clinician action in response to a reminder according to the number of reminders issued during the encounter, the number of problems on the patient's problem list, patient age, and time (number of months since launch) using logistic regression with clustering by encounter. There were issued 988,149 reminders at 453,537 encounters during the sampling frame. Action was taken in response to 60.1% of reminders, and discussion or consideration was documented in another 26.8%. The odds ratios for action in response to reminders over time, by number of prompts during the encounter, and by number of problems were 1.01, 1.18, and 1.02, respectively. Key design features included issuing reminders only when a service was due, allowing clinicians to attend to reminders when doing so fit their workflow (vs forcing attention at a specific time), keeping reminders very short and simple (action item only, no explicative material), and a team meeting and buy-in process before each new reminder was implemented. Reminder fatigue over time, with increasing numbers of reminders and with increasing complexity of patients, is not inevitable. A reminder system designed and implemented in accordance with the principles of cognitive science and human factors engineering can prevent reminder fatigue.

Twitter Demographics

The data shown below were collected from the profiles of 25 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 1 4%
Canada 1 4%
Unknown 23 92%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 20%
Student > Postgraduate 5 20%
Researcher 5 20%
Other 3 12%
Professor 2 8%
Other 5 20%
Readers by discipline Count As %
Medicine and Dentistry 11 44%
Nursing and Health Professions 5 20%
Computer Science 2 8%
Engineering 2 8%
Pharmacology, Toxicology and Pharmaceutical Science 1 4%
Other 4 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 May 2018.
All research outputs
#695,795
of 10,696,187 outputs
Outputs from Journal of the American Board of Family Medicine (formerly Journal of the American Board of Family Practice)
#139
of 908 outputs
Outputs of similar age
#21,386
of 223,663 outputs
Outputs of similar age from Journal of the American Board of Family Medicine (formerly Journal of the American Board of Family Practice)
#9
of 27 outputs
Altmetric has tracked 10,696,187 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 908 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.7. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 223,663 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 90% of its contemporaries.
We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.