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Li Y, Piao YR, Han TX, Mao HW. Clinical characteristics and treatment of splenic infarction in children with systemic lupus erythematosus. World J Pediatr 2024; 20:525-531. [PMID: 37561338 DOI: 10.1007/s12519-023-00748-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023]
Affiliation(s)
- Yan Li
- Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Key Laboratory for Genetics of Birth Defects, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Li Shi Lu, Beijing, 100045, China
| | - Yu-Rong Piao
- Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Key Laboratory for Genetics of Birth Defects, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Li Shi Lu, Beijing, 100045, China
| | - Tong-Xin Han
- Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Key Laboratory for Genetics of Birth Defects, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Li Shi Lu, Beijing, 100045, China
| | - Hua-Wei Mao
- Department of Immunology, Ministry of Education Key Laboratory of Major Diseases in Children, Beijing Key Laboratory for Genetics of Birth Defects, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, No. 56 Nan Li Shi Lu, Beijing, 100045, China.
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2
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Anderson R. Effects of an Electronic Health Record Tool on Team Communication and Patient Mobility: A 2-Year Follow-up Study. Crit Care Nurse 2022; 42:23-31. [PMID: 35362081 DOI: 10.4037/ccn2022385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Intensive care unit early mobility programs improve patients' functional status and outcomes. An electronic health record-based communication tool improved interprofessional communication within an early mobility program. Long-term sustainability of this communication tool has not been evaluated. LOCAL PROBLEM Ineffective interprofessional communication was perceived as a barrier to success of an intensive care unit early mobility program at the project institution. An electronic health record-based communication tool was successfully implemented to improve communication. Sustaining the intervention is of continued importance. METHODS Longitudinal data were collected 2 years after initial implementation of the communication tool to evaluate its continued impact on patient outcomes and staff engagement with an intensive care unit early mobility program. RESULTS Initial implementation of the electronic health record-based communication tool resulted in statistically and clinically significant improvements in patient and staff metrics. Compared with postimplementation data, 2-year longitudinal follow-up data revealed nonsignificant changes in patient outcomes (time from admission to mobility goal, mechanical ventilation duration, length of intensive care unit stay, and discharge disposition recommendations to higher independence levels). Staff reported continued use of the communication tool and positive perceptions of its impact on the intensive care unit early mobility program. CONCLUSIONS Nonsignificant changes in patient outcomes may indicate sustainment of the effect of the communication tool's original implementation. Employing appropriate sustainment techniques is essential to maintain practice change. The electronic health record-based communication tool can improve interprofessional communication within an intensive care unit early mobility program, improving patient outcomes and staff teamwork.
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Affiliation(s)
- Robert Anderson
- Robert Anderson is a pulmonary and critical care nurse practitioner, Mayo Clinic, Rochester, Minnesota
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Shriner AR, Baker RM, Ellis A, Dixon R, Saysana M. Improving Follow-Up of Tests Pending at Discharge. Hosp Pediatr 2021; 11:1363-1369. [PMID: 34849927 DOI: 10.1542/hpeds.2021-006000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Follow-up on results of inpatient tests pending at discharge (TPAD) must occur to ensure patient safety and high-quality care continue after discharge. We identified a need to improve follow-up of TPAD and began a quality improvement initiative with an aim of reducing the rate of missed follow-up of TPAD to ≤20% within 12 months. METHODS The team used the Plan-Do-Study-Act method of quality improvement and implemented a process using reminder messages in the electronic health record. We collected data via retrospective chart review for the 6 months before the intervention and monthly thereafter. The primary outcome measure was the percentage of patients with missed follow-up of TPAD, defined as no documented follow-up within 72 hours of a result being available. The use of a reminder message was monitored as a process measure. RESULTS We reviewed charts of 764 discharged patients, and 216 (28%) were noted to have TPAD. At baseline, the average percentage of patients with missed follow-up was 80%. The use of reminder messages was quickly adopted. The average percentage of patients with missed follow-up of TPAD after beginning the quality improvement interventions was 35%. CONCLUSIONS We had significant improvement in follow-up after our interventions. Additional work is needed to ensure continued and sustained improvement, focused on reducing variability in performance between providers and investing in technology to allow for automation of the follow-up process.
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Affiliation(s)
- Andrew R Shriner
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.,Department of Pediatrics, Section of Hospital Medicine School of Medicine, Indiana University, Indianapolis, Indiana
| | - Richelle M Baker
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.,Department of Pediatrics, Section of Hospital Medicine School of Medicine, Indiana University, Indianapolis, Indiana
| | - Andrew Ellis
- Mercy Children's Hospital, St Louis, Missouri.,Department of Child Health School of Medicine, University of Missouri, Columbia, Missouri
| | - Rebecca Dixon
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.,Department of Pediatrics, Section of Hospital Medicine School of Medicine, Indiana University, Indianapolis, Indiana
| | - Michele Saysana
- Riley Hospital for Children at Indiana University Health, Indianapolis, Indiana.,Department of Pediatrics, Section of Hospital Medicine School of Medicine, Indiana University, Indianapolis, Indiana
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Improving Communication Between Hospital and Outpatient Psychiatric Providers. Adv Emerg Nurs J 2021; 43:237-246. [PMID: 34397502 DOI: 10.1097/tme.0000000000000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients suffering from mental illness are often less likely to engage in treatment at an outpatient level. Lack of communication and coordination of care between providers has negative results for the health system and the patient. Improved communication has shown improved satisfaction of providers in health care. Using prior research, an electronic reminder and standardized documentation of communication was added to the health system's electronic health record. The aim of this quality improvement (QI) project was to compare pre-/postintervention communication and satisfaction between emergency department and outpatient psychiatric providers. The QI project was conducted on a convenience sample of 13 outpatient psychiatric providers at a large academic medical center. Using a pre-/postintervention design, QI project data were collected via chart reviews and pre-/postsurveys. The chart review results revealed the communication rate increased significantly from pre (22%) to post (85%), p < .001. The survey results revealed overall satisfaction had statistically significant increase from pre- (Mdn = 3, neutral) to postintervention (Mdn = 5, very satisfied), Z = -2.21, p =.027. The survey results revealed a statistically significant increase in frequency of direct communication from pre- (21%-40%) to postintervention (81%-100%), Z = -2.06, p = .039. The QI project documents an increase in both provider satisfaction and communication post-intervention.
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Downey E, Olds DM. Comparison of Documentation on Inpatient Discharge and Ambulatory End-of-Visit Summaries. J Healthc Qual 2021; 43:e43-e52. [PMID: 32544137 DOI: 10.1097/jhq.0000000000000269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Providing complete pending diagnostic test information and medication lists on inpatient discharge and ambulatory end-of-visit summaries decreases adverse events, reduces medical errors, and improves patient satisfaction. The purpose was to compare inpatient and ambulatory settings regarding percentages of records with documentation of pending diagnostic test result information and medication lists given at discharge/end of visit. METHODS Using a cross-sectional, observational design, 2018 NDNQI discharge/end-of-visit data from 133 inpatient and 90 ambulatory units in 20 hospitals were examined. Trained site coordinators reviewed records for documentation of discharge/end-of-visit elements. Mann-Whitney U tests were used to compare inpatient and ambulatory percent of elements completed. RESULTS Across all discharge/end-of-visit elements, there were differences (all p < .001) between inpatient and ambulatory settings. Ambulatory units had a lower percent completion for all medication list and pending diagnostic result elements. Depending on the element, the sample means for documentation in discharge/end-of-visit summaries were 18.6-98.8% for inpatient and 4.5-61.8% for ambulatory settings. CONCLUSIONS Discharge instructions and end-of-visit summaries are crucial forms of communication between clinicians and patients. However, many patients are not receiving complete information. IMPLICATIONS In a large nationwide sample, we found substantial opportunities to improve completeness of summaries, particularly in ambulatory settings.
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Challen R, Tsaneva-Atanasova K, Edwards T, Gompels L, Dayer M, Pitt M, Danon L. Factors influencing digital review of pathology test results in an inpatient setting: a cross-sectional study. JAMIA Open 2020; 3:290-298. [PMID: 32734170 PMCID: PMC7382616 DOI: 10.1093/jamiaopen/ooaa003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 11/27/2019] [Accepted: 02/05/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Delay or failure to view test results in a hospital setting can lead to delayed diagnosis, risk of patient harm, and represents inefficiency. Factors influencing this were investigated to identify how timeliness and completeness of test review could be improved through an evidence-based redesign of the use of clinical test review software. METHODS A cross-section of all abnormal hematology and biochemistry results which were published on a digital test review platform over a 3-year period were investigated. The time it took for clinicians to view these results, and the results that were not viewed within 30 days, were analyzed relative to time of the week, the detailed type of test, and an indicator of patient record data quality. RESULTS The majority of results were viewed within 90 min, and 93.9% of these results viewed on the digital platform within 30 days. There was significant variation in results review throughout the week, shown to be due to an interplay between technical and clinical workflow factors. Routine results were less likely to be reviewed, as were those with patient record data quality issues. CONCLUSION The evidence suggests that test result review would be improved by stream-lining access to the result platform, differentiating between urgent and routine results, improving handover of responsibility for result review, and improving search for temporary patient records. Altering the timing of phlebotomy rounds and a review of the appropriateness of routine test requests at the weekend may also improve result review rates.
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Affiliation(s)
- Robert Challen
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, Devon, UK
- Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - Krasimira Tsaneva-Atanasova
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, Devon, UK
- The Alan Turing Institute, British Library, London, UK
| | - Tom Edwards
- Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - Luke Gompels
- Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - Mark Dayer
- Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK
| | - Martin Pitt
- NIHR CLAHRC for the South West Peninsula, St Luke’s Campus, University of Exeter Medical School, Exeter, UK
| | - Leon Danon
- The Alan Turing Institute, British Library, London, UK
- Data Science Institute, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
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Test Result Management Practices of Canadian Internal Medicine Physicians and Trainees. J Gen Intern Med 2019; 34:118-124. [PMID: 30298242 PMCID: PMC6318178 DOI: 10.1007/s11606-018-4656-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/02/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Missed test results are a cause of medical error. Few studies have explored test result management in the inpatient setting. OBJECTIVE To examine test result management practices of general internal medicine providers in the inpatient setting, examine satisfaction with practices, and quantify self-reported delays in result follow-up. DESIGN Cross-sectional survey. PARTICIPANTS General internal medicine attending physicians and trainees (residents and medical students) at three Canadian teaching hospitals. MAIN MEASURES Methods used to track test results; satisfaction with these methods; personal encounters with results respondents "wish they had known about sooner." KEY RESULTS We received surveys from 33/51 attendings and 99/108 trainees (response rate 83%). Only 40.9% of respondents kept a record of all tests they order, and 50.0% had a system to ensure ordered tests were completed. Methods for tracking test results included typed team sign-out lists (40.7%), electronic health record (EHR) functionality (e.g., the electronic "inbox") (38.9%), and personal written or typed lists (14.8%). Almost all trainees (97.9%) and attendings (81.2%) reported encountering at least one test result they "wish they had known about sooner" in the past 2 months (p = 0.001). A higher percentage of attendings kept a record of tests pending at hospital discharge compared to trainees (75.0% vs. 35.7%, p < 0.001), used EHR functionality to track tests (71.4% vs. 27.5%, p = 0.004), and reported higher satisfaction with result management (42.4% vs. 12.1% satisfied or very satisfied, p < 0.001). CONCLUSIONS Canadian physicians report an array of problems managing test results in the inpatient setting. In the context of prior studies from the outpatient setting, our study suggests a need to develop interventions to prevent missed results and avoid potential patient harms.
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Wolfe L, Chisolm MS, Bohsali F. Clinically Excellent Use of the Electronic Health Record: Review. JMIR Hum Factors 2018; 5:e10426. [PMID: 30291099 PMCID: PMC6231887 DOI: 10.2196/10426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/27/2018] [Accepted: 07/17/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The transition to the electronic health record (EHR) has brought forth a rapid cultural shift in the world of medicine, presenting both new challenges as well as opportunities for improving health care. As clinicians work to adapt to the changes imposed by the EHR, identification of best practices around the clinically excellent use of the EHR is needed. OBJECTIVE Using the domains of clinical excellence previously defined by the Johns Hopkins Miller Coulson Academy of Clinical Excellence, this review aims to identify best practices around the clinically excellent use of the EHR. METHODS The authors searched the PubMed database, using keywords related to clinical excellence domains and the EHR, to capture the English-language, peer-reviewed literature published between January 1, 2000, and August 2, 2016. One author independently reviewed each article and extracted relevant data. RESULTS The search identified 606 titles, with the majority (393/606, 64.9%) in the domain of communication and interpersonal skills. Twenty-eight of the 606 (4.6%) titles were excluded from full-text review, primarily due to lack of availability of the full-text article. The remaining 578 full-text articles reviewed were related to clinical excellence generally (3/578, 0.5%) or the specific domains of communication and interpersonal skills (380/578, 65.7%), diagnostic acumen (31/578, 5.4%), skillful negotiation of the health care system (4/578, 0.7%), scholarly approach to clinical practice (41/578, 7.1%), professionalism and humanism (2/578, 0.4%), knowledge (97/578, 16.8%), and passion for clinical medicine (20/578, 3.5%). CONCLUSIONS Results suggest that as familiarity and expertise are developed, clinicians are leveraging the EHR to provide clinically excellent care. Best practices identified included deliberate physical configuration of the clinical space to involve sharing the screen with patients and limiting EHR use during difficult and emotional topics. Promising horizons for the EHR include the ability to augment participation in pragmatic trials, identify adverse drug effects, correlate genomic data to clinical outcomes, and follow data-driven guidelines. Clinician and patient satisfaction with the EHR has generally improved with time, and hopefully continued clinician, and patient input will lead to a system that satisfies all.
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Affiliation(s)
- Leah Wolfe
- Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Margaret Smith Chisolm
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Fuad Bohsali
- Department of Medicine, School of Medicine, Duke University, Durham, NC, United States
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9
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Whitehead NS, Williams L, Meleth S, Kennedy S, Epner P, Singh H, Wooldridge K, Dalal AK, Walz SE, Lorey T, Graber ML. Interventions to Improve Follow-Up of Laboratory Test Results Pending at Discharge: A Systematic Review. J Hosp Med 2018; 13:631-636. [PMID: 29489926 PMCID: PMC9491200 DOI: 10.12788/jhm.2944] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/29/2017] [Accepted: 12/17/2017] [Indexed: 01/25/2023]
Abstract
Failure to follow up test results pending at discharge (TPAD) from hospitals or emergency departments is a major patient safety concern. The purpose of this review is to systematically evaluate the effectiveness of interventions to improve follow-up of laboratory TPAD. We conducted literature searches in PubMed, CINAHL, Cochrane, and EMBASE using search terms for relevant health care settings, transition of patient care, laboratory tests, communication, and pending or missed tests. We solicited unpublished studies from the clinical laboratory community and excluded articles that did not address transitions between settings, did not include an intervention, or were not related to laboratory TPAD. We also excluded letters, editorials, commentaries, abstracts, case reports, and case series. Of the 9,592 abstracts retrieved, eight met the inclusion criteria and reported the successful communication of TPAD. A team member abstracted predetermined data elements from each study, and a senior scientist reviewed the abstraction. Two experienced reviewers independently appraised the quality of each study using published Laboratory Medicine Best Practices (LMBP™) A-6 scoring criteria. We assessed the body of evidence using the A-6 methodology, and the evidence suggested that electronic tools or one-on-one education increased documentation of pending tests in discharge summaries. We also found that automated notifications improved awareness of TPAD. The interventions were supported by suggestive evidence; this type of evidence is below the level of evidence required for LMBP™ recommendations. We encourage additional research into the impact of these interventions on key processes and health outcomes.
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Affiliation(s)
| | - Laurina Williams
- Centers for Disease Control and Prevention, Atlanta, Georgia
- Author for correspondence: Laurina Williams, PhD, MPH, Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology, and Laboratory Services, Division of Laboratory Systems,1600 Clifton Road, NE, MS G25, Atlanta, GA 30329; Telephone: 404-498-2267; Fax: 404-498-2215,
| | | | - Sara Kennedy
- RTI International, Research Triangle Park, North Carolina
| | | | - Hardeep Singh
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and Baylor College of Medicine, Houston, Texas
| | | | - Anuj K. Dalal
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Tom Lorey
- Kaiser Permanente Northern California, Berkeley, California
| | - Mark L. Graber
- RTI International, Research Triangle Park, North Carolina
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A Systematic Review of Interventions to Follow-Up Test Results Pending at Discharge. J Gen Intern Med 2018; 33:750-758. [PMID: 29352419 PMCID: PMC5910344 DOI: 10.1007/s11606-017-4290-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/12/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management. METHODS We searched Medline, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Database of Controlled Clinical Trials and Medline (January 1, 2000-November 10, 2016) for randomized controlled trials and prospective, controlled observational studies that evaluated interventions to improve follow-up of TPADs for adult patients discharged from acute care hospitals or emergency department settings. From each study we extracted characteristics of the intervention being evaluated and its impact on TPAD management. RESULTS Nine studies met the criteria for inclusion. Six studies evaluated electronic discharge summary templates with a designated field for documenting TPADs, and three of six of these studies reported a significant improvement in documentation of TPADs in discharge summaries in pre- and post-intervention analysis. One study reported that auditing discharge summaries and providing feedback to physicians were associated with improved TPAD documentation in discharge summaries. Two studies found that email alerts when TPADs were finalized improved physicians' awareness of the results and documentation of their follow-up actions. Of the four studies that assessed patient morbidity, two showed a positive effect; however, none specifically measured the impact of their interventions on downstream patient harm due to delayed follow-up of TPADs. Three studies surveyed physicians' attitudes towards the interventions, of which two studies reported improved physician satisfaction with TPAD management with the implementation of an enhanced discharge template and a notification system when TPADs finalize. DISCUSSION Discharge summary templates, educational interventions for discharging physicians, and email alerts when TPAD results are finalized show promise in improving management of TPADs. Given the complexity of the processes necessary to ensure follow-up of TPADs, rigorous evaluations of multifaceted interventions (e.g., improved discharge documentation of TPADs combined with email alerts when results become available) is needed.
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Pending Studies at the Time Hospital Discharge. J Gen Intern Med 2015; 30:1060. [PMID: 25896090 PMCID: PMC4510221 DOI: 10.1007/s11606-015-3321-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Williams C, Asi Y, Raffenaud A, Bagwell M, Zeini I. The effect of information technology on hospital performance. Health Care Manag Sci 2015; 19:338-346. [PMID: 26018176 DOI: 10.1007/s10729-015-9329-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 05/19/2015] [Indexed: 12/31/2022]
Abstract
While healthcare entities have integrated various forms of health information technology (HIT) into their systems due to claims of increased quality and decreased costs, as well as various incentives, there is little available information about which applications of HIT are actually the most beneficial and efficient. In this study, we aim to assist administrators in understanding the characteristics of top performing hospitals. We utilized data from the Health Information and Management Systems Society and the Center for Medicare and Medicaid to assess 1039 hospitals. Inputs considered were full time equivalents, hospital size, and technology inputs. Technology inputs included personal health records (PHR), electronic medical records (EMRs), computerized physician order entry systems (CPOEs), and electronic access to diagnostic results. Output variables were measures of quality, hospital readmission and mortality rate. The analysis was conducted in a two-stage methodology: Data Envelopment Analysis (DEA) and Automatic Interaction Detector Analysis (AID), decision tree regression (DTreg). Overall, we found that electronic access to diagnostic results systems was the most influential technological characteristics; however organizational characteristics were more important than technological inputs. Hospitals that had the highest levels of quality indicated no excess in the use of technology input, averaging one use of a technology component. This study indicates that prudent consideration of organizational characteristics and technology is needed before investing in innovative programs.
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Affiliation(s)
- Cynthia Williams
- Department of Public Health, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA.
| | - Yara Asi
- College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA
| | - Amanda Raffenaud
- College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA
| | - Matt Bagwell
- College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA
| | - Ibrahim Zeini
- College of Health & Public Affairs, University of Central Florida, Orlando, Fl, USA
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Walz SE. Capsule commentary on Kantor et al. Pending studies at hospital discharge: a pre-post analysis of an electronic medical record tool to improve communication at hospital discharge. J Gen Intern Med 2015; 30:345. [PMID: 25560314 PMCID: PMC4351272 DOI: 10.1007/s11606-014-3110-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Stacy E Walz
- Department of Clinical Laboratory Sciences, Arkansas State University-Jonesboro, P.O. Box 910, State University, AR, 72467, USA,
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Srinivasan M. When life span exceeds health span. J Gen Intern Med 2015; 30:267-8. [PMID: 25650258 PMCID: PMC4351270 DOI: 10.1007/s11606-014-3167-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Malathi Srinivasan
- University of California Davis School of Medicine, 4150 V. Street, Suite 2400, Sacramento, CA, 95833, USA,
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