# Cancer Patient Safety Learning Laboratory (CaPSLL): Preventing Clinical Deterioration in Outpatients

> **NIH AHRQ R18** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2020 · $601,720

## Abstract

Project Summary/Abstract
 A common cause of preventable harm is the failure to detect and appropriately respond to clinical
deterioration. Timely intervention is needed, particularly in medically complex (e.g., cancer) patients, to
mitigate the effects of adverse events, disease progression, and medical error. This challenging problem
requires effective clinical surveillance, early recognition, timely notification of the appropriate clinician,
and effective intervention. In the hospital setting, “failure to rescue” (FTR) is a recognized safety failure.
To address FTR, hospitals have introduced new tools and processes (e.g., continuous monitoring, early
warning systems, and `Rapid Response' teams). Yet, `death in bed' remains common.
 The Vanderbilt-Ingram Cancer Center, in collaboration with human factors and systems engineering
faculty in the Center for Research and Innovation in Systems Safety (CRISS), as well as faculty in our
Schools of Engineering and Management, will create the Cancer Patient Safety Learning Laboratory
(CaPSLL). We will partner with surgeons, oncologists, nurses, staff, and adult patients with lung and head
or neck cancer recovering from and/or undergoing treatment as outpatients, and their lay caregivers, to
more reliably detect and respond more effectively to unexpected clinical deterioration. The details that
follow in this proposal are based on our current understandings but will be modified as we employ a
systems engineering oriented user-centered design (UCD) process to analyze, design, develop, implement,
and evaluate innovative tools and processes to address this complex patient safety problem.
 We will achieve this through three Specific Aims: 1) To create and refine software tools and a
predictive model for a surveillance-and-response system to prevent harm from unexpected all-cause
clinical deterioration in outpatients receiving cancer treatment; 2) To create and refine processes and
training that engage patients and their caregivers as active and reliable participants in detecting and
reporting potential clinical deterioration. We will apply high reliability organizational (HRO) principles
and theories to develop processes and training for the relevant “team” – the cancer patients, their
caregivers, and the clinicians who need to respond to signals from the surveillance system; and 3) To
implement in the operational environment and formally evaluate the integrated detection and response
tools and processes. We hypothesize (H1) that this system will decrease the likelihood and severity of
unplanned treatment events (UTE; e.g. hospital admission). Further, with the incorporation of a
patient/family focused HRO framework, we hypothesize that the system will increase non-routine event
(NRE; deviations from optimal care) reporting (H2) and decrease clinician response time (H3). The
resulting tools, methods and predictive model will be scalable to other cancer types as well as being
generalizable to other institutions...

## Key facts

- **NIH application ID:** 10007891
- **Project number:** 5R18HS026616-03
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** DANIEL Joseph FRANCE
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $601,720
- **Award type:** 5
- **Project period:** 2018-09-30 → 2022-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10007891

## Citation

> US National Institutes of Health, RePORTER application 10007891, Cancer Patient Safety Learning Laboratory (CaPSLL): Preventing Clinical Deterioration in Outpatients (5R18HS026616-03). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10007891. Licensed CC0.

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