8 results on '"Callen, Joanne"'
Search Results
2. Pathology's front line – a comparison of the experiences of electronic ordering in the Clinical Chemistry and Haematology departments.
- Author
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Westbrook, Johanna I., Coiera, Enrico W., Callen, Joanne L., Aarts, Jos, Georgiou, Andrew, Lang, Stephen, Alvaro, Frank, Whittaker, Geoff, and Callen, Joanne
- Abstract
Socio-technical approaches to health information systems evaluation are particularly relevant to the study of Computerised Provider Order Entry (CPOE) systems. Pathology services are made up of a number of departments each with unique and complex tasks and requirements. These different components of pathology have received very little research attention. This study used qualitative methods to identify key organisational and work process along with repercussions of the implementation of CPOE through a comparison of the Haematology and Clinical Chemistry departments of a hospital pathology service. The results focus attention on areas where the departments face similar challenges along with those areas where work practices diverged. This underlined the key importance of understanding the context and setting of pathology laboratories. The study also draws attention to the importance of cross departmental and multi-disciplinary negotiation in the implementation process and highlights the potential for technology to affect and be affected by the organisational context in which it is placed. [ABSTRACT FROM AUTHOR]
- Published
- 2007
3. Does an integrated Emergency Department Information System change the sequence of clinical work? A mixed-method cross-site study.
- Author
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Callen, Joanne, Li, Ling, Georgiou, Andrew, Paoloni, Richard, Gibson, Kathryn, Li, Julie, Stewart, Michael, Braithwaite, Jeffrey, and Westbrook, Johanna I.
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INFORMATION storage & retrieval systems , *TELEMEDICINE , *PATIENT management , *ELECTRONIC health records , *DATA quality - Abstract
Objectives (1) to describe Emergency Department (ED) physicians’ and nurses’ perceptions about the sequence of work related to patient management with use of an integrated Emergency Department Information System (EDIS), and (2) to measure changes in the sequence of clinician access to patient information. Methods A mixed method study was conducted in four metropolitan EDs. Each used the same EDIS which is a module of the hospitals’ enterprise-wide clinical information system composed of many components of an electronic medical record. This enabled access to clinical and management information relating to patients attending all hospitals in the region. Phase one – data were collected from ED physicians and nurses ( n = 97) by 69 in-depth interviews, five focus groups (28 participants), and 26 h of observations. Phase two – physicians ( n = 34) in one ED were observed over 2 weeks. Data included whether and what type of information was accessed from the EDIS prior to first examination of the patient. Results Clinicians reported, and phase 2 observations confirmed, that the integrated EDIS led to changes to the order of information access, which held implications for when tests were ordered and results accessed. Most physicians accessed patient information using EDIS prior to taking the patients’ first medical history (77/116; 66.4%, 95% CI: 57.8–75.0%). Previous discharge summaries (74%) and past test results (61%) were most frequently accessed and junior doctors were more likely to access electronic past history information than their senior colleagues ( χ 2 = 20.717, d.f. = 1, p < 0.001). Conclusions The integrated EDIS created new ways of working for ED clinicians. Such changes could hold positive implications for: time taken to reach a diagnosis and deliver treatments; length of stay; patient outcomes and experiences. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
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4. Can technology change the work of nurses? Evaluation of a drug monitoring system for ambulatory chronic disease patients
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Callen, Joanne, Hordern, Antonia, Gibson, Kathryn, Li, Ling, Hains, Isla M., and Westbrook, Johanna I.
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DRUG monitoring , *CHRONICALLY ill , *RHEUMATOLOGY , *URBAN hospitals , *IMMUNOSUPPRESSIVE agents , *QUANTITATIVE research - Abstract
Abstract: Objective: To evaluate the impact of an electronic drug monitoring system (eDMS) for ambulatory rheumatology patients on time nurses spent on, and the process of, drug monitoring. Methods: The study was conducted in the Rheumatology Department of a large metropolitan hospital. The eDMS, a module of the Hospital Clinical Information System (HCIS), was designed to allow electronic ordering and subsequent monitoring of ambulatory patients on long-term, immunosuppressive rheumatology medications. Quantitative measures collected before and after the intervention were: time spent on specific nursing activities; who nurses spent time with; format and location of documentation monitoring; and patient throughput. Qualitative data from interviews and observations were collected to ascertain the impact of the eDMS on nurses’ monitoring activities. Results: Nurses spent significantly less time on medication monitoring tasks (33.1% versus 26.4%, P =0.003) and significantly more time on patient care (6.5–18.1%, P <0.0001) following implementation of the eDMS. Nurses also spent significantly more time with patients (7.7–19.8%, P <0.0001) and relatives (0.4–3.7%, P =0.01) after the system was implemented. The time saved on monitoring allowed the number of nurse directed clinics and patient throughput to increase following eDMS implementation. Qualitative data supported results from the timing study with nurses reporting that the monitoring process was more standardised, safer, took less time and simplified documentation. Conclusions: The eDMS was associated with a reduction in time spent on the complex task of medication monitoring allowing nurses to spend a greater proportion of their time on other patient care activities. [Copyright &y& Elsevier]
- Published
- 2013
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5. Use of an electronic drug monitoring system for ambulatory patients with chronic disease: How does it impact on nurses' time spent documenting clinical care?
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Maeder, Anthony J., Martin-Sanchez, Fernando J., Hordern, Antonia, Callen, Joanne, Gibson, Kathryn, Robertson, Louise, Li, Ling, Hains, Isla M., and Westbrook, Johanna I.
- Abstract
Medication monitoring of ambulatory rheumatology patients on Disease Modifying Anti-Rheumatic Drugs (DMARDS) is time consuming and complex, with possibilities for error. Electronic systems have the potential to improve the process. The aim of this study was to evaluate the impact of an electronic Drug Monitoring System (eDMS) on the time nurses' spent on clinical documentation associated with monitoring. The study was conducted with all nurses (n=4) in the Rheumatology Department of a large metropolitan Australian teaching hospital. The eDMS was designed as a module of the Hospital Clinical Information System (HCIS) to assist clinicians in monitoring rheumatology patients on DMARDS. Timing data were collected using a modified time and motion work measurement technique using software on a handheld computer. Data included the time nurses spent on documentation regarding medication monitoring before and after the implementation of the eDMS. Results showed that following implementation of the eDMS nurses spent significantly less time documenting medication monitoring information (13.6% to 7.2%, P<.0001). The cumbersome paper-based Drug Monitoring Patient List was replaced entirely by the eDMS. Consequently, there was a significant decrease in the time nurses spent using the HCIS (13.01% to 2.8%, p<.0001) for monitoring and the use of loose-leaf paper also decreased (7.6% to 5.0%, p = 0.002). The eDMS made the process of drug monitoring quicker and simpler for nurses and thus permitted them to increase their time spent in direct patient care. [ABSTRACT FROM AUTHOR]
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- 2012
6. Information and Communication Processes in the Microbiology Laboratory – Implications for Computerised Provider Order Entry.
- Author
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Kuhn, Klaus A., Warren, James R., Leong, Tze-Yun, Georgiou, Andrew, Callen, Joanne, Westbrook, Johanna, Prgomet, Mirela, and Toouli, George
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The aim of this multi-method study based at a microbiology department in a major Sydney metropolitan teaching hospital was to: i) identify the role that information and communication processes play in a paper-based test request system, and ii) examine how these processes may affect the implementation and design of Computerised Provider Order Entry (CPOE) systems. Participants in this study reported that clinical information can impact on the urgency and type of tests undertaken and affect the interpretation of test results. An audit of 1051 microbiology test request forms collected over a three-day period showed that 47% of request forms included clinical notes which provide a variety of information often vital to the test analysis and reporting process. This transfer of information plays an important role in the communication relationship between the ward and the laboratory. The introduction of new CPOE systems can help to increase the efficiency of this process but for that to be achieved research attention needs to be given to enhancing the provision and communication of clinical information. [ABSTRACT FROM AUTHOR]
- Published
- 2007
7. Does health information technology improve acknowledgement of radiology results for discharged emergency department patients? A before and after study
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Ling Li, William B. Runciman, Joanne Callen, Richard Paoloni, Andrew Georgiou, Julie Li, Johanna I. Westbrook, Li, Julie, Paoloni, Richard, Li, Ling, Callen, Joanne, Westbrook, Johanna I, Runciman, William B, and Georgiou, Andrew
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medicine.medical_specialty ,Health information technology ,Acknowledgement ,Health Informatics ,lcsh:Computer applications to medicine. Medical informatics ,01 natural sciences ,Health informatics ,Evaluation studies ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,evaluation studies ,medicine ,Electronic Health Records ,Humans ,Medical errors ,medical informatics ,Abnormal Finding ,Clinical significance ,030212 general & internal medicine ,0101 mathematics ,Duty to recontact ,business.industry ,Health Policy ,010102 general mathematics ,Australia ,Emergency department ,Patient Discharge ,radiology ,3. Good health ,Computer Science Applications ,Test (assessment) ,Medical informatics ,medical errors ,lcsh:R858-859.7 ,Radiology ,duty to recontact ,business ,Emergency Service, Hospital ,Research Article - Abstract
Background The inadequate follow-up of test results is a key patient safety concern, carrying severe consequences for care outcomes. Patients discharged from the emergency department are at particular risk of having test results pending at discharge due to their short lengths of stay, with many hospitals acknowledging that they do not have reliable systems for managing such results. Health information technology hold the potential to reducing errors in the test result management process. This study aimed to measure changes in the proportion of acknowledged radiology reports pre and post introduction of an electronic result acknowledgement system and to determine the proportion of reports with abnormal results, including clinically significant abnormal results requiring follow-up action. Methods A before and after study was conducted in the emergency department of a 450-bed metropolitan teaching hospital in Australia. All radiology reports for discharged patients for a one-month period before and after implementation of the electronic result acknowledgement system were reviewed to determine; i) those that reported abnormal results; ii) evidence of test result acknowledgement. All unacknowledged radiology results with an abnormal finding were assessed by an independent panel of two senior emergency physicians for clinical significance. Results Of 1654 radiology reports in the pre-implementation period 70.6% (n = 1167) had documented evidence of acknowledgement by a clinician. For reports with abnormal results, 71.6% (n = 396) were acknowledged. Of 157 unacknowledged abnormal radiology reports reviewed by an independent emergency physician panel, 34.4% (n = 54) were identified as clinically significant and 50% of these (n = 27) were deemed to carry a moderate likelihood of patient morbidity if not followed up. Electronic acknowledgement occurred for all radiology reports in the post period (n = 1423), representing a 30.4% (95% CI: 28.1–32.6%) increase in acknowledgement rate, and an increase of 28.4% (95% CI: 24.6–32.2%) for abnormal radiology results. Conclusions The findings of this study demonstrate the potential of health information technology to improve the safety and effectiveness of the diagnostic process by increasing the rate of follow up of results pending at hospital discharge.
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- 2020
8. What do physicians tell laboratories when requesting tests? A multi-method examination of information supplied to the Microbiology laboratory before and after the introduction of electronic ordering
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Georgiou, Andrew, Prgomet, Mirela, Toouli, George, Callen, Joanne, and Westbrook, Johanna
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DIAGNOSTIC microbiology , *BIOINFORMATICS , *PATHOLOGY , *MEDICAL information storage & retrieval systems , *DIAGNOSTIC specimens , *FECES examination , *TRAUMATOLOGY diagnosis - Abstract
Abstract: Background: The provision of relevant clinical information on pathology requests is an important part of facilitating appropriate laboratory utilization and accurate results interpretation and reporting. Purpose: (1) To determine the quantity and importance of handwritten clinical information provided by physicians to the Microbiology Department of a hospital pathology service; and (2) to examine the impact of a Computerized Provider Order Entry (CPOE) system on the nature of clinical information communication to the laboratory. Methods: A multi-method and multi-stage investigation which included: (a) a retrospective audit of all handwritten Microbiology requests received over a 1-month period in the Microbiology Department of a large metropolitan teaching hospital; (b) the administration of a survey to laboratory professionals to investigate the impact of different clinical information on the processing and/or interpretation of tests; (c) an expert panel consisting of medical staff and senior scientists to assess the survey findings and their impact on pathology practice and patient care; and (d) a comparison of the provision and value of clinical information before CPOE, and across 3 years after its implementation. Results: The audit of handwritten requests found that 43% (n =4215) contained patient-related clinical information. The laboratory survey showed that 97% (84/86) of the different types of clinical information provided for wound specimens and 86% (43/50) for stool specimens were shown to have an effect on the processing or interpretation of the specimens by one or more laboratory professionals. The evaluation of the impact of CPOE revealed a significant improvement in the provision of useful clinical information from 2005 to 2008, rising from 90.1% (n =749) to 99.8% (n =915) (p <.0001) for wound specimens and 34% (n =129) to 86% (n =422) (p <.0001) for stool specimens. Conclusion: This study showed that the CPOE system provided an integrated platform to access and exchange valuable patient-related information between physicians and the laboratory. These findings have important implications for helping to inform decisions about the design and structure of CPOE screens and what data entry fields should be designated or made voluntary. [Copyright &y& Elsevier]
- Published
- 2011
- Full Text
- View/download PDF
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