Table 2.

Patient safety learning laboratory project: implementation challenges and recommendations by category

Category	Challenge	Recommendation
Stakeholder Engagement	User variety: (MD, PA, RN, Patients, Caregivers, Unit Directors, etc.), 3 clinical services (Oncology, General Medicine, Neurology)	Create an interdisciplinary leadership and champion team Leverage areas of common interest across user types Incorporate a patient-centered communication system (eg, Patient SatisfActive model2,4,12,13)
	Project Complexity	Develop clear, effective messaging Maintain consistent communication with stakeholders
	Change fatigue	Understand demand on users and competing priorities Align with institutional priorities
	Requirement for Enduring Engagement	Leverage existing unit meetings Align with compliance reporting Reward use with virtual prizes and competition
Project Scope/Complexity	Multiple products designed for different user groups (clinician vs patient) with different use cases	Curate and convey the project’s united theme Create a central graphic for “advertising” Demonstrate willingness to be flexible
	Multiplicity of sites (units) for implementation	Respond to unit variability with socio-technical approach, limited modification of tools, and work flow flexibility20 Leverage human factors/systems engineering
	Varied implementation/ training needs	Implement via stepped wedge to allow for focused, staggered support Create printed reference tools for training Train all staff
Technology/ Governance	Technical bugs	Respond to user issues quickly (when possible) Set expectations about resource constraints Pilot technology multiple times
	Project and scope management	Leverage administrative core to maintain project scope against institutional pressures Create development requirements and timeline (“perfection” vs progress) Establish postimplementation productization scope
	Development of usable, helpful products	Use iterative user-centered design process Accommodate all users via human factors engineering
	Data access	Leverage existing organizational data resources Align with institutional priorities Centralize all project data requests
Team Structure	Varied and wide-ranging research assistant (RA) tasks	Ensure that all RAs are trained uniformly Establish daily RA “huddles”
	Co-investigator involvement in training and support	Involve co-investigators with clinical knowledge and experience (RNs, MDs) in end-user training
	Risk mitigation	Encourage an open dialogue about project challenges Document and disseminate key learnings amongst team members

Abbreviations: MD, medical doctor; PA, physician assistant; RA, research assistant; RN, registered nurse.