AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
-
AMIA Annu Symp Proc · Jan 2005
Leveraging point-of-care clinician feedback to study barriers to guideline adherence.
Studies of barriers to guideline adherence have generally surveyed clinicians temporally remote from the clinical scenario in which recommendations were delivered, potentially adversely biasing clinician observations. The user interface of ATHENA DSS, a guideline-based decision support system for hypertension, includes a point-of-care feedback window that accepts clinician-user comments during the display of recommendations. Analysis of this feedback has revealed a number of intriguing patient, provider, and technical barriers to adherence collected during real-time system use.
-
Health messages are crucial to the field of public health in effecting behavior change, but little research is available to assist writers in composing the overall structure of a message. In order to develop software to assist non-expert message writers in constructing effective messages, the structure of existing health messages must be understood, and an appropriate method for analyzing health message structure developed. ⋯ A novel framework for characterizing health message structure and a method for analyzing messages appears to be reproducible.
-
AMIA Annu Symp Proc · Jan 2005
Physician perspective on computerized order-sets with embedded guideline information in a commercial emergency department information system.
Computerized provider order entry (CPOE) is a promising conduit for medical knowledge in support of guideline-consistent decision-making at the point of care. While there are many published examples of successful implementations of CPOE with decision support, there remain questions about the effectiveness of commercially available information system products, particularly in the emergency department (ED). ⋯ Physicians reported that they liked the CPOE order-sets better than the paper version and did use the order-sets, but guide-line compliance did not improve. Cultural and organizational issues as well as limitations in the functionality of the commercial system appear to have limited the effectiveness of this implementation.
-
Redesigns of workflow to allow parallel processing of OR tasks in the Operating Room of the Future at Massachusetts General Hospital have reduced non-operative time, increasing OR throughput. Automatically gathered anesthesia times were studied to address concerns that the new process constricted anesthesia work time. Upon close examination, it was found that 'Induction Time' was the only time interval not impacted by extraneous influences that invalidated other metrics based on the automatic data. 'Induction Time' increased in the Operating Room of the Future as compared to Standard Operating Rooms.
-
AMIA Annu Symp Proc · Jan 2005
Effect of Computerized Nursing Documentation on Clinical Care Activities in a Neonatal Intensive Care Unit (NICU).
A point of care computerized nursing documentation system is being evaluated to determine if the implementation resulted in a timesaving for neonatal nurse practitioners (NNP) while preparing for patient rounds. A benefit of the hypothesized decreased work process is earlier initiation of care changes thus improving care quality. Observable activities within the work process were timed before and again 4 months after implementation of the computerized nursing documentation system. Data will be analyzed and results reported.