# PROMIS Learning Lab: Partnership in Resilience for Medication Safety

> **NIH AHRQ R18** · UNIVERSITY OF TEXAS ARLINGTON · 2020 · $625,000

## Abstract

We propose to create a learning laboratory for patient safety in primary care. The Partnership in
Resilience for Medication Safety Learning Lab (PROMIS Lab) redesigns primary care work systems to address
multiple types of medication related harms among older adults through collaborating with clinics and patients,
including those in low socio-economic status. Preventable patient harms from medications such as opioids are
significant threats to patient safety in ambulatory and community settings and contributed 700,000 emergency
department visits each year. More than a third of community-dwelling 65 years or older adults take 5 or more
prescription medications. In ambulatory and community settings, more so than in inpatient settings, medication
safety is shaped by interactions among patient/family and different professionals across locations. The
PROMIS Lab develops much needed strategies in primary care where professionals are in a unique position to
partner with patients and community caregivers to reduce risks of medication-related preventable harms, such
as polypharmacy and inaccurate medication information, and to cope with setbacks and disturbances that
threaten safety. Our team is uniquely positioned to take systems engineering approach to partnership building.
We will work with two “in-situ lab” clinics from a practice-based research network for problem analysis, design
and evaluation. The PROMIS Lab includes community partners to involve older adults and their caregivers in
design cycles, and a network of informant clinics for observations and learning. We will conduct design and
tests a simulated outpatient care suite. Patients and home caregivers frequently encounter disturbances
induced by healthcare system, community, family and patient factors. The PROMIS Lab innovates solutions in
patient safety in an “open” community environment by focusing on enhancing capacity for resilient actions to
dynamically forestall, mitigate, and recover from failures and in achieving success in medication safety in
community settings. We will use the well-known systems engineering approach to achieve its goals: problem
analysis (Aim1), design and development (Aim 2), implementation and evaluation (Aim 3). Aim #1. Identify and
define primary care work system design requirements to address commonly occurring medication related
safety hazards and to enable resilient performance through partnership. Aim #2. Improve the value of primary
care services using work system design strategies, such as informational tools, task redesign, and space
layout, to enable and build capacity for resilient performance. Aim #3. Implement and evaluate redesign work
system components at 2 primary care clinics. The PROMIS Lab's long term impact will be insights and
innovative, yet practical tools, design guidelines, and collaboration support strategies for teamwork beyond
clinic walls, to effectively partner with clinicians, pharmacists, patients and families to reduce inappropria...

## Key facts

- **NIH application ID:** 10016289
- **Project number:** 5R18HS027277-02
- **Recipient organization:** UNIVERSITY OF TEXAS ARLINGTON
- **Principal Investigator:** Yan Xiao
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $625,000
- **Award type:** 5
- **Project period:** 2019-09-30 → 2023-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10016289

## Citation

> US National Institutes of Health, RePORTER application 10016289, PROMIS Learning Lab: Partnership in Resilience for Medication Safety (5R18HS027277-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10016289. Licensed CC0.

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