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Start Over Topic academic medical centers Publication Year Range Last 50 years
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1. Intensive care unit readmission prevention checklist: is it worth the effort?

Author

Smischney, Nathan J., Cawcutt, Kelly A., O'Horo, John C., Sevilla Berrios, Ronaldo A., and Whalen, Francis X.

Subjects
*ACADEMIC medical centers, *ATTITUDE (Psychology), *EXPERIMENTAL design, *INTENSIVE care units, *LONGITUDINAL method, *RESEARCH methodology, *MEDICAL personnel, *SCIENTIFIC observation, *CROSS-sectional method, *ACUTE diseases, *PATIENT readmissions, *DISEASE complications, DISEASE relapse prevention
Abstract

Rationale, aims and objectives Checklists have been adopted by various institutions to improve patient outcomes. In particular, readmission prevention checklists may be of potential value to improve patient care and reduce medical costs. As a result, a prior quality improvement study was conducted to create an intensive care unit readmission prevention checklist. The previous pilot demonstrated zero readmissions when the readmission prevention checklist was utilized but yielded low compliance (30%). Thus, a subsequent quality initiative was undertaken to refine the readmission prevention checklist with the primary aim of improved compliance while maintaining a reduced readmission rate that was observed with the original quality improvement study. Method A single-centre, cross-sectional study for assessing baseline data and a prospective observational study to assess the effectiveness of a refined readmission prevention checklist tool in a 20-bed tertiary medical-surgical intensive care unit at an academic medical centre in Rochester, MN was conducted. Medical patients admitted through the emergency department, upon direct transfer from outside facility, and post-operative surgical patients at our institution were included. A refined readmission prevention checklist tool was administered during an 8-week pilot period for medical and post-operative surgical patients. Results The refined readmission prevention checklist resulted in an even lower compliance (10.5%) from the initial phase likely resulting from utilization of a paper readmission prevention checklist in an electronic medical environment. Moreover, the refined readmission prevention checklist demonstrated a 22% unplanned readmission rate for patients in which the tool was utilized. Conclusions In conclusion, the findings of the current quality improvement study may serve to rethink the process of health care delivery that applies paper tools in an electronic medical environment. [ABSTRACT FROM AUTHOR]

Published
2014
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2. Academic medicine - revolution, evolution or extinction?

Author

Gareth W, Irwin, Roy A J, Spence, Danny F, McAuley, Richard D, Kennedy, Keith R, Gardiner, and J Stuart, Elborn

Subjects
Paper, Academic Medical Centers, Career Mobility, Career Choice, Education, Medical, Humans, Northern Ireland, State Medicine
Published
2014

3. Assessment of the impact on time to complete medical record using an electronic medical record versus a paper record on emergency department patients: a study

Author

Jeffrey J. Perry, Katie Dorland, Ian G. Stiell, Cheryl Symington, Jane Sutherland, and Marlène Mansour

Subjects
Adult, Male, Paper, Chest Pain, Time Factors, Writing, Documentation, Critical Care and Intensive Care Medicine, Chest pain, Tertiary care, Risk Assessment, Sensitivity and Specificity, Medical Records, Healthcare delivery, Medicine, Electronic Health Records, Humans, Aged, Academic Medical Centers, business.industry, Medical record, Electronic medical record, General Medicine, Emergency department, Middle Aged, medicine.disease, Test (assessment), Emergency Medicine, Female, Medical emergency, Forms and Records Control, medicine.symptom, business, Emergency Service, Hospital
Abstract

Electronic medical records are becoming an integral part of healthcare delivery.The goal of this study was to compare paper documentation versus electronic medical record for non-traumatic chest pain to determine differences in time for physicians to complete medical records using paper versus electronic mediums. We also assessed physician satisfaction with the electronic format.We conducted this before-after study in a single large tertiary care academic emergency department. In the 'Before Period', stopwatches determined the time for paper medical recording. In the 'After Period', a template-based electronic medical record was introduced and the time for electronic recording was measured. The time to record in the before and after periods were compared using a two-sided t test. We surveyed physicians to assess satisfaction.We enrolled 100 non-traumatic patients with chest pain in the before period and 73 in the after period. The documentation time was longer using electronic charting, (9.6±5.9 min vs 6.1±2.5 min; p0.001). 18 of 20 physicians participating in the after period completed surveys. Physicians were not satisfied with the electronic patient recording for non-traumatic chest pain.This is the first study that we are aware of which compared paper versus electronic medical records in the emergency department. Electronic recording took longer than paper records. Physicians were not satisfied using this electronic record. Given the time pressures on emergency physicians, a solution to minimise the charting time using electronic medical records must be found before widespread uptake of electronic charting will be possible.

Published
2013

4. Can a large institution go paperless?

Author

D Z, Sands, D M, Rind, C, Vieira, and C, Safran

Subjects
Paper, Systems Integration, Academic Medical Centers, Massachusetts, Medical Records Systems, Computerized, Cost Savings, Hospital Information Systems, Humans, Organizational Objectives, Medical Record Linkage, Medical Records
Abstract

Since 1989, Beth Israel Hospital has been deploying an extensive online patient record (the OMR), which augmented a heavily used integrated hospital information system. Initially begun in a large primary care practice, the system is now used to share patient records among 36 practices on three campuses. Although the system was intended to eliminate the need for paper, we have found that it has, in the short term, increased the amount of paper produced. Elimination of paper record in ambulatory care has saved us $56,000, but we have yet to realize the savings of an additional $200,000 per year. We explore the factors that contribute to this "paper paradox" and discuss the costs associated with increased paper production, areas in which we have reduced paper handling, and strategies for reducing our reliance on paper.

Published
1999