Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2010
Discuss now, document later: CIS/CPOE perceived to be a 'shift behind' in the ICU.
Effective communication is essential to safe and efficient patient care. We aimed to understand the current patterns and perceptions of communication of common goals in the ICU using the distributed cognition and clinical communication space theoretical frameworks. ⋯ These perceptions that the CIS/CPOE is a "shift behind" may lead to a further reliance on verbal information exchange, which is a valuable clinical communication activity, yet, is subject to information loss. Electronic documentation tools that, in real time, capture information that is currently verbally communicated may increase the effectiveness of communication.
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Stud Health Technol Inform · Jan 2010
MET3-AE system to support management of pediatric asthma exacerbation in the emergency department.
A decision making process behind the management of pediatric patients with asthma exacerbations in the Emergency Department includes three stages: data collection, diagnosis formulation and treatment planning. These stages are associated with activities involving different types of clinical knowledge: factual, conceptual and procedural. Effective decision support should span over the entire decision making process and facilitate the use of diversified clinical knowledge. ⋯ It was developed using ontology-driven and multi-agent methodologies and implemented with open source software. The system is accessible on tablet and desktop computers and smartphones, and it interacts with other hospital information systems. It was successfully verified in a simulated clinical setting and now it is undergoing testing in a teaching hospital.
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Stud Health Technol Inform · Jan 2010
Socio-technical challenges in implementing safe patient handovers.
Ineffective handovers in patient care, including those where information loss occurs between care providers, have been identified as a risk to patient safety. Computerization of health information is often offered as a solution to improve the quality of care handovers and decrease adverse events related to patient safety. Drawing on three ethnographic case studies we identify and discuss socio-technical issues which must be addressed if computerized health information systems are to achieve improvements in patient safety related to handovers in care. We suggest that the contextual nature of information, ethical and medico-legal issues arising in relation to information handover and data standards and system integration warrant ongoing research in socio-technical aspects of care handovers.
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This study addresses the question of the respective impact of organizational vs. technical environment variables on the collaborative aspects of healthcare work situations. It analyzes the physicians-nurses communications during the medication use process, according to both the organization of their work and their technical environment. ⋯ The study (i) presents the identification and description of the communications' processes involving doctors-nurses face-to-face communications and the supports that mediate medication information and (ii) focuses on the amount of face-to-face communications depending on the organization of work and the technical system used. The analyses demonstrate that the organizational variables have a larger impact than the technical environment on the quality and quantity of the communications and cooperation activities.
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Stud Health Technol Inform · Jan 2010
Development and initial validation of a disease specific outcome measure for early onset scoliosis.
Treatment of children with early onset scoliosis (EOS) seeks to improve natural history and health related quality of life (QOL). QOL measurement presents a significant challenge given the young age, comorbidities, and heterogeneity of this population. ⋯ The EOSQ reflects QOL and caregiver burden in the EOS population. The EOSQ will expand options for outcome assessment in this unique population.