Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2012
Evidence based electronic system to ensure quality of care in trauma patients.
Electronic patient records are important for quality health services. Aim of this study is to support the trauma patient care with the development of an electronic system. A survey was conducted in the Emergency Department (ED) of a University hospital to study the effectiveness of an electronic monitoring system in a group of trauma patients, as well as the acceptance of this electronic system by the health professionals of the ED. ⋯ The severity, length of care and the health outcomes of 200 trauma patients, were investigated. Half of the patients (N=100) have been monitored by the electronic system and the other 100 were monitored without the use of the system. The time between the admission and completion of the planned care was significantly lower in the electronic monitoring patient group (100±92 minutes) compared to the control group (149±29 minutes).
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Electronic Health Record (EHR) data has the potential to track patients' journeys through healthcare systems. Many of those journeys are supposed to follow Integrated Care Pathways (ICPs) built on evidence based guidelines. An ICP for a particular condition sets out "what should happen", whereas the EHR records "what did happen". ⋯ By performing variance analysis over multiple patients, patterns of deviation from idealised care are revealed. The use of ICP variance analysis, however, is not as widespread as it could be in healthcare quality improvement processes - we argue that this is due to the difficulty of combining the required specialist knowledge and skills from different disciplines. COCPIT (Collaborative Online Care Pathway Investigation Tool) was developed to overcome this difficulty and provides clinicians and health service managers with a web-based tool for Care Pathway Variance Analysis.
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Stud Health Technol Inform · Jan 2012
User preference comparing a conventional videolaryngoscope blade vs. a novel suction videolaryngoscope blade in simulated hemorrhagic airway intubation.
The hemorrhagic airway makes visualization during laryngoscopy and intubation difficult. A specially designed videolaryngoscope blade with integrated suction was developed and studied in a simulated hemorrhagic airway at the Omaha VA Medical Center. Results show that, if available, many users would choose to include this new suction device in their standard airway carts due to its "always there" design.
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Stud Health Technol Inform · Jan 2012
Use of a cardiac algorithm in a preoperative evaluation clinic - a pilot study.
The preoperative evaluation is vital in providing information to reduce the risks associated with the anesthesia and surgery and improve the quality of care. In the VA Nebraska-Western Iowa Health Care System, we introduced a computer-based cardiac algorithm as part of the preoperative evaluation software. Following the pre-op examination and use of the algorithm, the provider completed a survey regarding their perceived usefulness of the algorithm software. The survey results showed that effective preoperative evaluation can be performed using a preoperative evaluation clinic, users are receptive to the computer-based format and, in most cases, prefer to have the algorithm software available for use in preoperative assessment.
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Stud Health Technol Inform · Jan 2012
Identifying types and causes of errors in mortality data in a clinical registry using multiple information systems.
Errors may occur in the registration of in-hospital mortality, making it less reliable as a quality indicator. We assessed the types of errors made in in-hospital mortality registration in the clinical quality registry National Intensive Care Evaluation (NICE) by comparing its mortality data to data from a national insurance claims database. Subsequently, we performed site visits at eleven Intensive Care Units (ICUs) to investigate the number, types and causes of errors made in in-hospital mortality registration. ⋯ The remaining 20% were five types of manual transcription errors and human failures to record outcome data. Clinical registries should be aware of the possible existence of errors in recorded outcome data and understand their causes. In order to prevent errors, we recommend to thoroughly verify the software that is used in the registration process.