Journal for healthcare quality : official publication of the National Association for Healthcare Quality
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This article examines the degree to which healthcare information technology (HIT) supporting the Institute of Medicine's (IOM) six care aims is utilized in the hospital setting and explores organizational factors associated with HIT use. Guided by the IOM's Crossing the quality chasm report and associated literature, 27 applications and/or capabilities are classified according to one or more of the six care aims. A structured survey of Florida hospitals identified the use of HIT. Results suggest that, on average, hospitals have not yet embraced HIT to support the IOM's care aims and that associated organizational factors vary according to care aim.
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Patient safety, in particular, medication safety, has become a major issue for healthcare providers, payers, and patients. Medication errors occur at an alarming rate, and the majority of non-intercepted medication errors originate at the point of care when a nurse mistakenly administers a medication. The 1999 Institute of Medicine report called for increasing the use of information technology to reduce medication errors. Realizing a 59% to 70% decrease in medication administration errors on individual nursing units, this hospital demonstrates how bar code point-of-care medication administration systems successfully track, reduce, and prevent bedside medicationerrors while having a positive effect on nursing satisfaction.
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David Brailer, MD PhD, was appointed the first National Health Information Technology Coordinator by the U. S. Department of Health and Human Services Secretary Tommy Thompson on May 6, 2004. ⋯ Dana Scholar at the University of Pennsylvania School of Medicine and the first recipient of the National Library of Medicine Martin Epstein Award for his work in expert systems. Dr. Brailer was among the first medical students to serve on the Board of Trustees of the American Medical Association.
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Clinical performance monitoring data on processes of care from a 3-year period were used to assess whether preventive foot care was associated with improved health outcomes in diabetes mellitus patients. Preventive foot care as well as sensory and pedal-pulse examinations were associated with reduced rates of Lower extremity amputation. It is believed that an administrative focus, resource direction, and improvement in process monitoring will lead to better patient outcomes. External review measures can be used by administrators and cLinicians to determine trends in quality of care and patient outcomes andto provide feedback on prevention efforts.
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Healthcare quality professionals need to understand and use inferential statistics to interpret sample data from their organizations. Since in quality improvement and healthcare research studies, all the data from a population often are not available, investigators take samples and make inferences about that population using inferential statistics. This series of six articles will give readers an understanding of the concepts of inferential statistics, as well as the specific tools for calculating confidence intervals and tests of statistical significance for samples of data. ⋯ This article, Part 4, starts with a review of the information contained in Parts 1, 2, and 3, which appeared in the July/August 2003 issue of the Journal for Healthcare Quality. This article describes t distributions and how these are used to calculate confidence intervals for estimating a population mean based on a sample mean of a continuous variable. Part 4 concludes with a discussion of standard error, margin of error, and confidence intervals for estimating a population proportion based on a sample proportion from a binomial variable.