J Am Med Inform Assoc - The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature.

Tópicos

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Resumo

JECTIVE: To assess evidence of the impact of Picture Archiving and Communication Systems (PACS) on clinicians' work practices in the intensive care unit (ICU).METHODS: We searched Medline, Pre-Medline, CINAHL, Embase, and the SPIE Digital Library databases for English-language publications between 1980 and September 2010 using Medical Subject Headings terms and keywords.RESULTS: Eleven studies from the USA and UK were included. All studies measured aspects of time associated with the introduction of PACS, namely the availability of images, the time a physician took to review an image, and changes in viewing patterns. Seven studies examined the impact on clinical decision-making, with the majority measuring the time to image-based clinical action. The effect of PACS on communication modes was reported in five studies.DISCUSSION: PACS can impact on clinician work practices in three main areas. Most of the evidence suggests an improvement in the efficiency of work practices. Quick image availability can impact on work associated with clinical decision-making, although the results were inconsistent. PACS can change communication practices, particularly between the ICU and radiology; however, the evidence base is insufficient to draw firm conclusions in this area.CONCLUSION: The potential for PACS to impact positively on clinician work practices in the ICU and improve patient care is great. However, the evidence base is limited and does not reflect aspects of contemporary PACS technology. Performance measures developed in previous studies remain relevant, with much left to investigate to understand how PACS can support new and improved ways of delivering care in the intensive care setting.

Resumo Limpo

jectiv assess evid impact pictur archiv communic system pac clinician work practic intens care unit icumethod search medlin premedlin cinahl embas spie digit librari databas englishlanguag public septemb use medic subject head term keywordsresult eleven studi usa uk includ studi measur aspect time associ introduct pac name avail imag time physician took review imag chang view pattern seven studi examin impact clinic decisionmak major measur time imagebas clinic action effect pac communic mode report five studiesdiscuss pac can impact clinician work practic three main area evid suggest improv effici work practic quick imag avail can impact work associ clinic decisionmak although result inconsist pac can chang communic practic particular icu radiolog howev evid base insuffici draw firm conclus areaconclus potenti pac impact posit clinician work practic icu improv patient care great howev evid base limit reflect aspect contemporari pac technolog perform measur develop previous studi remain relev much left investig understand pac can support new improv way deliv care intens care set

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