Richard Griffey, MD, MPH: Preventing Adverse Events in Diabetic Ketoacidosis Using a Standardized Care Pathway in the Emergency Department: A Pilot Study.
Richard T. Griffey, MD, MPH, is a professor of emergency medicine and general medical education director for patient safety and quality improvement at the Washington University in St. Louis, School of Medicine – Department of Emergency Medicine.
Preventing Adverse Events in Diabetic Ketoacidosis Using a Standardized Care Pathway in the Emergency Department: A Pilot Study (June 2017-May 2018).
Dr. Griffey’s pilot implemented a standardized care pathway to treat diabetic ketoacidosis in the emergency department, to improve process of care measures and patient outcomes. Working with a multidisciplinary team, a pathway was developed to modify those used in intensive care units, standardizing DKA care in the Emergency Department.
This initial funding resulted in two publications, providing the preliminary results for a novel Emergency Department tool, and preliminary data for an AHRQ R01 for a Multicenter Study of the Emergency Department Trigger Tool (R01HS027811, September 2020-July 2025, $1.531 million FY24 Total Cost).
This multicenter project is designed to test the broad application of a novel tool for detecting adverse events, including DKA, to continue to improve adverse event detection by applying natural language processing and machine learning. Since receiving his PFP award, Dr. Griffey has been promoted to Professor of Emergency Medicine, Vice Chair for Patient Safety & Quality, and GME Director for the Patient Safety & Quality Improvement Section at WU School of Medicine.
Related Grants:
- NIH, Multicenter Study of the Emergency Department Trigger Tool, September 2020 – July 2025
- NIH, Demonstration project to refine, automate and test a novel emergency department trigger tool, September 2016 – August 2020
Related Publications:
- SQuID (subcutaneous insulin in diabetic ketoacidosis): Clinician acceptability.
- The problem with the existing reporting standards for adverse event and medical error research.
- Social Determinants of Health and Health Literacy in Emergency Patients with Diabetic Ketoacidosis.
- SQuID (subcutaneous insulin in diabetic ketoacidosis) II: Clinical and operational effectiveness.
- Putting SQuID on the menu: A subcutaneous insulin protocol for diabetic ketoacidosis.
- Triage Point-of-Care Ketone Measurements: Association With Diabetic Ketoacidosis and Severity.
- The Clinical Emergency Data Registry: Structure, Use, and Limitations for Research.
- The emergency department trigger tool: Multicenter trigger query validation.
- The SQuID protocol (subcutaneous insulin in diabetic ketoacidosis): Impacts on ED operational metrics.
- Impact of Predictive Text Clinical Decision Support on Imaging Order Entry in the Emergency Department.
- Near-Miss Events Detected Using the Emergency Department Trigger Tool.
- Emergency clinician participation and performance in the Centers for Medicare & Medicaid Services Merit-based Incentive Payment System.
- Emergency Department Adverse Events Detected Using the Emergency Department Trigger Tool.
- Why identifying adverse events in paediatric emergency care matters.
- Near-Miss Events Detected Using the Emergency Department Trigger Tool.
- Emergency Department Adverse Events Detected Using the Emergency Department Trigger Tool.
- Protocol for DRAUP: a deimplementation programme to decrease routine chest radiographs after central venous catheter insertion.
- Practical Considerations in Use of Trigger Tool Methodology in the Emergency Department.
- Post-Acute and Long-Term Care Patients Account for a Disproportionately High Number of Adverse Events in the Emergency Department.
- Multicenter Test of an Emergency Department Trigger Tool for Detecting Adverse Events.
- Trigger Tools for Adverse Event Detection in the Emergency Department.
- The Emergency Department Trigger Tool: Validation and Testing to Optimize Yield.
- Adverse Events Present on Arrival to the Emergency Department: The ED as a Dual Safety Net.
- Counseling on Access to Lethal Means-Emergency Department (CALM-ED): A Quality Improvement Program for Firearm Injury Prevention.
- The Emergency Department Trigger Tool: A Novel Approach to Screening for Quality and Safety Events.
- Description and Yield of Current Quality and Safety Review in Selected US Academic Emergency Departments.
- Critical Review, Development, and Testing of a Taxonomy for Adverse Events and Near Misses in the Emergency Department.
- Current Practices in Central Venous Catheter Position Confirmation by Point of Care Ultrasound: A Survey of Early Adopters.