Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2014
Mid-term NEAT review: analysing the improvements in hospital ED performance.
Introduced with a promise to reduce overcrowding in the Emergency Department (ED) and the associated morbidity and mortality linked to bed access difficulties, the National Emergency Access Target (NEAT) is now over halfway through transitionary arrangements towards a target of 90% of patients that visit a hospital ED being admitted or discharged within 4 hours. Facilitation and reward funding has ensured hospitals around the country are remodelling workflows to ensure compliance. ⋯ Our findings reveal that, while most hospitals have made significant improvements to their 4 hour discharge performance in 2013, the underlying flow patterns and periods of poor NEAT compliance remain largely unchanged. The work identifies areas for targeted improvement to inform system redesign and workflow planning.
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Stud Health Technol Inform · Jan 2014
A service oriented approach for guidelines-based clinical decision support using BPMN.
Evidence-based medical practice requires that clinical guidelines need to be documented in such a way that they represent a clinical workflow in its most accessible form. In order to optimize clinical processes to improve clinical outcomes, we propose a Service Oriented Architecture (SOA) based approach for implementing clinical guidelines that can be accessed from an Electronic Health Record (EHR) application with a Web Services enabled communication mechanism with the Enterprise Service Bus. ⋯ The aim of this study is to produce spontaneous alerts in the healthcare workflow in the diagnosis of Chronic Obstructive Pulmonary Disease (COPD). The use of BPMN as a tool to automate clinical guidelines has not been previously employed for providing Clinical Decision Support (CDS).
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Stud Health Technol Inform · Jan 2014
Analysis of operating theatre utilisation to drive efficiency and productivity improvements.
There is an urgent need in the acute health system to use resources as efficiently as possible. One such group of resources are operating theatres, which have an important impact on patient flow through a hospital. ⋯ It was found that day-long sessions (as opposed to separate morning or afternoon sessions), mid-week sessions, certain specialties (eg. neurosurgery sessions) and not doing the longest case first were most beneficial to theatre utilisation. Awareness of these findings is important in any redesign activity aimed at improving flow performance.
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Stud Health Technol Inform · Jan 2014
Observational StudyClinical documentation improvement for outpatients by implementing electronic medical records.
This observational study was conducted before and after implementing an electronic medical record (EMR) system to evaluate the change in outpatient workflow by implementation of EMR and the effectiveness of clinical documentation improvement (CDI). The number of hours for patient care increased by 89.2% (p < .05) and the hours for writing medical records after consulting decreased after implementation of EMR by 27.3% (p < .01). ⋯ The necessary change in the information management process occurred after using the CDI indicator. We recommend that the "working hours of health professionals" and "handling hours for information resources" should be used widely as CDI indicators to improve workflow when implementing EMR.
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Stud Health Technol Inform · Jan 2014
An open-source, mobile-friendly search engine for public medical knowledge.
The World Wide Web has become an important source of information for medical practitioners. To complement the capabilities of currently available web search engines we developed FindMeEvidence, an open-source, mobile-friendly medical search engine. In a preliminary evaluation, the quality of results from FindMeEvidence proved to be competitive with those from TRIP Database, an established, closed-source search engine for evidence-based medicine.