Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2012
Early discharge and its effect on ED length of stay and access block.
Effecting early discharge is a widely recommended strategy for improving patient flow in acute hospitals. This paper analyses the impact of inpatient discharge timing on Emergency Department (ED) flow parameters such as access block and length of stay, while comparing this to the effect on hospital occupancy, to arrive at an understanding of a 'whole of hospital' response to discharge timing. ⋯ The analysis reveals that, on days when the discharge peak lags the peak in inpatient admissions, hospitals of all sizes exhibit increased levels of occupancy, inpatient and ED length of stay, and access block. The findings corroborate the efficacy of early discharge initiatives and 'whole of hospital' flow improvement initiatives for addressing overcrowding and efficiency issues in hospitals.
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Stud Health Technol Inform · Jan 2012
Use of a virtual integrated environment in prosthetic limb development and phantom limb pain.
Patients face two major difficulties following limb loss: phantom limb pain (PLP) in the residual limb and limited functionality in the prosthetic limb. Many studies have focused on decreasing PLP with mirror therapy, yet few have examined the same visual ameliorating effect with a virtual or prosthetic limb. ⋯ Preliminary results show an overall reduction in PLP and a trend toward improvement in signal-to-motion accuracy over time. These signals allowed MPL users to perform a wide range of hand motions.
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Stud Health Technol Inform · Jan 2012
Using EHR data for monitoring and promoting patient safety: reviewing the evidence on trigger tools.
Trigger tools, both paper and automated, have been viewed as a promising technology for patient record content analysis and identification of patient safety adverse events. The requirements and potential barriers for implementation of each line of tools have been explored by means of a literature review focusing on two interconnected subject areas: the Institute of Healthcare Improvement's paper-based Global Trigger Tool, which is currently taken up by several national level patient safety programs, and automated trigger tools, because of their increased feasibility as electronic health record (EHR) adoption grows. This paper provides an overview of the existing evidence on the strengths and weaknesses of each approach, and discusses the implications of the findings from the perspectives of healthcare organizations' management and staff, and from the viewpoint of demands on EHR systems.
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As a young ensign in the US Navy on a nuclear submarine, Doug Bonacum had to brief the captain of the ship following his night-time shift, reporting about potentially dangerous situations that might emerge. He described the "situation, background, assessment, and recommendation". ⋯ SBAR has been implemented in "real-world" environments with excellent results. We are implementing SBAR to facilitate communication in CliniSpace among caregivers in this 3D immersive, virtual learning environment.
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Stud Health Technol Inform · Jan 2012
What do radiology incident reports reveal about in-hospital communication processes and the use of health information technology?
There has been recent rapid growth in the use of medical imaging leading to concerns about an increase in unnecessary investigations, patient exposure to radiation, and incorrect diagnoses. Incident reporting systems provide a portal for staff to catalogue adverse events which occur within a hospital or department. Analysing incident reports can reveal trends and provide guidance for quality improvement efforts. ⋯ Communication breakdown and HIT systems are contributors to error, and should be addressed. HIT systems need to be monitored and flaws addressed to ensure quality care.