The following is a summary of “Implementation of Prediction Models in the Emergency Department from an Implementation Science Perspective—Determinants, Outcomes, and Real-World Impact: A Scoping Review,” published in the July 2023 issue of Emergency Medicine by Chan et al.

Prediction models present a hopeful form of clinical decision support within the intricate and rapidly evolving emergency department (ED) setting. Despite notable progress in model development and validation, integrating these models into regular clinical practice remains challenging. This scoping review intends to examine the present condition of prediction model implementation in the emergency department (ED) and offer insights on contributing factors and outcomes from the implementation science perspective. Researchers conducted a comprehensive search across four medical databases, MEDLINE (via PubMed), Embase, Scopus, and CINAHL, from their respective beginnings to May 20, 2022. 

Included in the analysis were articles that documented implementation outcomes and contextual determinants within the framework of the Reach, Effectiveness, Adoption, Implementation Maintenance (RE-AIM)/Practical, Robust, Implementation, and Sustainability Model (PRISM). The characteristics of studies, models, and results about the RE-AIM/PRISM domains were succinctly summarized narratively. About 36 medical reports on 31 medical implementations were included. The most prevalent prognostic models employed were early warning scores. The most pervasive implementation strategies employed encompassed the education of stakeholders, modifications to infrastructure, and the utilization of evaluative or iterative approaches.

Only one study investigated patients’ perspectives on erectile dysfunction (ED). In contrast, the remaining studies were primarily focused on the experiences of healthcare professionals or individuals involved in the healthcare organization. Critical factors for successful implementation in the medical field include active involvement of stakeholders, collaborative development of workflows and implementation strategies, comprehensive education, and ensuring usability. Analyzing emergency department (ED) prediction models from a medical implementation science standpoint can offer valuable insights and assist future implementations.

Source: sciencedirect.com/science/article/pii/S0196064423000963