J Am Med Inform Assoc - Impact of an electronic medication management system on hospital doctors' and nurses' work: a controlled pre-post, time and motion study.

Tópicos

{ care(1570) inform(1187) nurs(1089) }
{ chang(1828) time(1643) increas(1301) }
{ intervent(3218) particip(2042) group(1664) }
{ medic(1828) order(1363) alert(1069) }
{ patient(2837) hospit(1953) medic(668) }
{ group(2977) signific(1463) compar(1072) }
{ control(1307) perform(991) simul(935) }
{ state(1844) use(1261) util(961) }
{ time(1939) patient(1703) rate(768) }
{ studi(1410) differ(1259) use(1210) }
{ measur(2081) correl(1212) valu(896) }
{ patient(2315) diseas(1263) diabet(1191) }
{ age(1611) year(1155) adult(843) }
{ gene(2352) biolog(1181) express(1162) }
{ implement(1333) system(1263) develop(1122) }
{ estim(2440) model(1874) function(577) }
{ model(3404) distribut(989) bayesian(671) }
{ inform(2794) health(2639) internet(1427) }
{ motion(1329) object(1292) video(1091) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ cost(1906) reduc(1198) effect(832) }
{ first(2504) two(1366) second(1323) }
{ patient(1821) servic(1111) care(1106) }
{ use(2086) technolog(871) perceiv(783) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ clinic(1479) use(1117) guidelin(835) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ design(1359) user(1324) use(1319) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ risk(3053) factor(974) diseas(938) }
{ perform(999) metric(946) measur(919) }
{ research(1085) discuss(1038) issu(1018) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ signal(2180) analysi(812) frequenc(800) }
{ sampl(1606) size(1419) use(1276) }
{ data(3008) multipl(1320) sourc(1022) }
{ activ(1138) subject(705) human(624) }
{ can(981) present(881) function(850) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ survey(1388) particip(1329) question(1065) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

JECTIVE: To quantify and compare the time doctors and nurses spent on direct patient care, medication-related tasks, and interactions before and after electronic medication management system (eMMS) introduction.METHODS: Controlled pre-post, time and motion study of 129 doctors and nurses for 633.2 h on four wards in a 400-bed hospital in Sydney, Australia. We measured changes in proportions of time on tasks and interactions by period, intervention/control group, and profession.RESULTS: eMMS was associated with no significant change in proportions of time spent on direct care or medication-related tasks relative to control wards. In the post-period control ward, doctors spent 19.7% (2 h/10 h shift) of their time on direct care and 7.4% (44.4 min/10 h shift) on medication tasks, compared to intervention ward doctors (25.7% (2.6 h/shift; p=0.08) and 8.5% (51 min/shift; p=0.40), respectively). Control ward nurses in the post-period spent 22.1% (1.9 h/8.5 h shift) of their time on direct care and 23.7% on medication tasks compared to intervention ward nurses (26.1% (2.2 h/shift; p=0.23) and 22.6% (1.9 h/shift; p=0.28), respectively). We found intervention ward doctors spent less time alone (p=0.0003) and more time with other doctors (p=0.003) and patients (p=0.009). Nurses on the intervention wards spent less time with doctors following eMMS introduction (p=0.0001).CONCLUSIONS: eMMS introduction did not result in redistribution of time away from direct care or towards medication tasks. Work patterns observed on these intervention wards were associated with previously reported significant reductions in prescribing error rates relative to the control wards.

Resumo Limpo

jectiv quantifi compar time doctor nurs spent direct patient care medicationrel task interact electron medic manag system emm introductionmethod control prepost time motion studi doctor nurs h four ward bed hospit sydney australia measur chang proport time task interact period interventioncontrol group professionresult emm associ signific chang proport time spent direct care medicationrel task relat control ward postperiod control ward doctor spent h h shift time direct care min h shift medic task compar intervent ward doctor hshift p minshift p respect control ward nurs postperiod spent h h shift time direct care medic task compar intervent ward nurs hshift p hshift p respect found intervent ward doctor spent less time alon p time doctor p patient p nurs intervent ward spent less time doctor follow emm introduct pconclus emm introduct result redistribut time away direct care toward medic task work pattern observ intervent ward associ previous report signific reduct prescrib error rate relat control ward

Resumos Similares

Int J Med Inform - Can technology change the work of nurses? Evaluation of a drug monitoring system for ambulatory chronic disease patients. ( 0,722205507185464 )
Telemed J E Health - Communication strategies and timeliness of response to life critical telemetry alarms. ( 0,715969542251852 )
J. Med. Internet Res. - An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study. ( 0,692204277460778 )
AMIA Annu Symp Proc - A mixed methods approach for measuring the impact of delivery-centric interventions on clinician workflow. ( 0,687357449622209 )
Int J Med Inform - Managing variations from surgical care plans: challenges for coordination. ( 0,672869479638339 )
Comput. Biol. Med. - Smart medical environment at the point of care: auto-tracking clinical interventions at the bed side using RFID technology. ( 0,652783504206529 )
BMC Med Inform Decis Mak - National survey focusing on the crucial information needs of intensive care charge nurses and intensivists: same goal, different demands. ( 0,649810836905231 )
J Am Med Inform Assoc - The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals. ( 0,649302979762598 )
Int J Med Inform - Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? a mixed methods evaluation. ( 0,647917582869522 )
AMIA Annu Symp Proc - A software communication tool for the tele-ICU. ( 0,646843158815382 )
J Telemed Telecare - Perception, satisfaction and utilization of the VALUE home telehealth service. ( 0,645092802644121 )
Int J Med Inform - The fungibility of time in claims of efficiency: the case of making transmission of prescriptions electronic in English general practice. ( 0,643326962932082 )
Telemed J E Health - TEAhM-Technologies for Enhancing Access to Health Management: a pilot study of community-based telehealth. ( 0,640577901857461 )
Telemed J E Health - Examining perceptions of a smartphone-based intervention system for alcohol use disorders. ( 0,637873884760762 )
Telemed J E Health - Home telehealth: facilitators, barriers, and impact of nurse support among high-risk dialysis patients. ( 0,635337430910236 )
BMC Med Inform Decis Mak - Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment. ( 0,633348263270474 )
Int J Med Inform - Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly. ( 0,631910217210816 )
Appl Clin Inform - The effects of health information technology change over time: a study of Tele-ICU functions. ( 0,631906817471879 )
Int J Med Inform - Perceptions of urgency: defining the gap between what physicians and nurses perceive to be an urgent issue. ( 0,630622943526457 )
BMC Med Inform Decis Mak - Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. ( 0,629115898745597 )
J. Med. Internet Res. - Effects of an individually tailored Web-based chronic pain management program on pain severity, psychological health, and functioning. ( 0,626503009379241 )
Int J Med Inform - Exploring practice variation in preventive pressure-ulcer care using data from a clinical data repository. ( 0,622038617388415 )
Int J Med Inform - Does an integrated Emergency Department Information System change the sequence of clinical work? A mixed-method cross-site study. ( 0,621205986182865 )
J Am Med Inform Assoc - The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature. ( 0,619817651159881 )
Appl Clin Inform - Use of clinical decision support to improve the quality of care provided to older hospitalized patients. ( 0,618731823828201 )
AMIA Annu Symp Proc - Development of a nursing handoff tool: a web-based application to enhance patient safety. ( 0,618212237456598 )
BMC Med Inform Decis Mak - The status of IT service management in health care - ITIL? in selected European countries. ( 0,615232650393476 )
J Med Syst - Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit. ( 0,611936713284 )
J Am Med Inform Assoc - A patient-centered longitudinal care plan: vision versus reality. ( 0,605998262008583 )
Telemed J E Health - Analysis of the impact of the Birmingham OwnHealth program on secondary care utilization and cost: a retrospective cohort study. ( 0,603268746306953 )
Int J Med Inform - Impact of IT-supported clinical pathways on medical staff satisfaction. A prospective longitudinal cohort study. ( 0,60177228898751 )
Int J Med Inform - Effects of laboratory data exchange in the care of patients with HIV. ( 0,598473134368902 )
J Telemed Telecare - Automated home telephone self-monitoring reduces hospitalization in patients with advanced heart failure. ( 0,597418768307895 )
Perspect Health Inf Manag - Incorporating patient perspectives into the personal health record: implications for care and caring. ( 0,595129031916386 )
Telemed J E Health - Telehealth group interactions in the hospice setting: assessing technical quality across platforms. ( 0,590930058637177 )
J. Med. Internet Res. - Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial. ( 0,590108398032256 )
AMIA Annu Symp Proc - A real-time screening alert improves patient recruitment efficiency. ( 0,586809251835054 )
Int J Med Inform - Do no harm: fortifying MDT collaboration in changing technological times. ( 0,586167345442191 )
Appl Clin Inform - Novel computerized health risk appraisal may improve longitudinal health and wellness in primary care: a pilot study. ( 0,583666247742832 )
Appl Clin Inform - Understanding interprofessional communication: a content analysis of email communications between doctors and nurses. ( 0,58282256017044 )
Health Informatics J - The coordination hub: Toward patient-centered and collaborative care processes. ( 0,582154398175869 )
J Telemed Telecare - The effect of PACS on the practice of orthopaedic surgeons. ( 0,581941694502992 )
Int J Med Inform - Effect of a nursing information system on the quality of information processing in nursing: An evaluation study using the HIS-monitor instrument. ( 0,58178309902951 )
AMIA Annu Symp Proc - Falling through the cracks: information breakdowns in critical care handoff communication. ( 0,580757743145346 )
Telemed J E Health - Patient-clinician mobile communication: analyzing text messaging between adolescents with asthma and nurse case managers. ( 0,5804419612772 )
Int J Med Inform - Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication. ( 0,579400667979303 )
Telemed J E Health - Implementing home blood glucose and blood pressure telemonitoring in primary care practices for patients with diabetes: lessons learned. ( 0,578723345148242 )
J. Med. Internet Res. - Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study. ( 0,578595083899932 )
Int J Med Inform - Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow. ( 0,575737257223937 )
J Biomed Inform - Bridging gaps in handoffs: a continuity of care based approach. ( 0,575320239069897 )
BMC Med Inform Decis Mak - Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system. ( 0,572808396558817 )
Telemed J E Health - A systematic review of clinician and staff views on the acceptability of incorporating remote monitoring technology into primary care. ( 0,572352850639751 )
Int J Med Inform - Implementation and evaluation of an integrated computerized asthma management system in a pediatric emergency department: a randomized clinical trial. ( 0,572307820339344 )
AMIA Annu Symp Proc - Inter-observer reliability assessments in time motion studies: the foundation for meaningful clinical workflow analysis. ( 0,571644455380388 )
J Am Med Inform Assoc - Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness. ( 0,568363446541468 )
J Am Med Inform Assoc - Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units. ( 0,56764333815047 )
AMIA Annu Symp Proc - The orderly and effective visit: impact of the electronic health record on modes of cognitive control. ( 0,566392870482826 )
Int J Med Inform - A model of awareness to enhance our understanding of interprofessional collaborative care delivery and health information system design to support it. ( 0,56619244792899 )
Int J Med Inform - Going paperless at the emergency department: a socio-technical study of an information system for patient tracking. ( 0,566091551184829 )
BMC Med Inform Decis Mak - Validation of the Work Observation Method By Activity Timing (WOMBAT) method of conducting time-motion observations in critical care settings: an observational study. ( 0,5660490805864 )
BMC Med Inform Decis Mak - Methods to identify, study and understand end-user participation in HIT development. ( 0,565052577019915 )
J Med Syst - Prioritizing barriers to successful implementation of hospital information systems. ( 0,564836871623512 )
Healthc (Amst) - Association of medical home team-based care functions and perceived improvements in patient-centered care at VHA primary care clinics. ( 0,564534010922826 )
Inform Health Soc Care - Information exchange between registered nurses and district nurses during the discharge planning process: cross-sectional analysis of survey data. ( 0,564324294492011 )
J. Med. Internet Res. - Attrition and adherence in a WEB-Based Distress Management Program for Implantable Cardioverter defibrillator Patients (WEBCARE): randomized controlled trial. ( 0,563723748956354 )
Int J Med Inform - Barriers and facilitators to the use of computer-based intensive insulin therapy. ( 0,562993916274778 )
Int J Med Inform - Use of electronic information systems in nursing management. ( 0,56197301890836 )
Int J Med Inform - Comparing the working time between Bar-Code Medication Administration system and traditional medication administration system: an observational study. ( 0,559631371591392 )
J Telemed Telecare - The benefits of e-health support for older family caregivers in rural areas. ( 0,559306729419408 )
Int J Med Inform - Health information exchange interventions can enhance quality and continuity of HIV care. ( 0,559168897972098 )
Int J Med Inform - Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow. ( 0,558618069150905 )
J Clin Monit Comput - Differential effects of propofol and sevoflurane on QT interval during anesthetic induction. ( 0,557306439659659 )
Appl Clin Inform - Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site. ( 0,555555555555556 )
BMC Med Inform Decis Mak - Impact of a chronic kidney disease registry and provider education on guideline adherence--a cluster randomized controlled trial. ( 0,555074604635801 )
Appl Clin Inform - Registers for Networked Medical Research in Germany: Situation and prospects. ( 0,554259237517591 )
Int J Med Inform - Adoption of a clinical decision support system to promote judicious use of antibiotics for acute respiratory infections in primary care. ( 0,553598873705655 )
Int J Med Inform - The impact of medical record technologies on collaboration in emergency medicine. ( 0,550019098216927 )
J Am Med Inform Assoc - Quantifying care coordination using natural language processing and domain-specific ontology. ( 0,549174061215659 )
Healthc (Amst) - When scaling prevention means scaling demand: Voluntary medical male circumcision in Nyanza Province, Kenya. ( 0,548795472456028 )
BMC Med Inform Decis Mak - Participatory eHealth development to support nurses in antimicrobial stewardship. ( 0,548712135796461 )
Int J Med Inform - The importance of the verbal shift handover report: a multi-site case study. ( 0,548067227746563 )
Telemed J E Health - Task-technology fit of video telehealth for nurses in an outpatient clinic setting. ( 0,548035395262424 )
Int J Med Inform - Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: an intervention study. ( 0,54791949529448 )
J Am Med Inform Assoc - Patient portal doldrums: does an exam room promotional video during an office visit increase patient portal registrations and portal use? ( 0,547429315369495 )
J Am Med Inform Assoc - Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use. ( 0,547387989587517 )
BMC Med Inform Decis Mak - Implementation and evaluation of a nurse-centered computerized potassium regulation protocol in the intensive care unit--a before and after analysis. ( 0,545472155247943 )
AMIA Annu Symp Proc - Examining the Multi-level Fit between Work and Technology in a Secure Messaging Implementation. ( 0,54411321610856 )
Appl Clin Inform - Assessment of readiness for clinical decision support to aid laboratory monitoring of immunosuppressive care at U.S. liver transplant centers. ( 0,542948426308221 )
J. Med. Internet Res. - Development of an interactive, Web-delivered system to increase provider-patient engagement in smoking cessation. ( 0,540691074622664 )
BMC Med Inform Decis Mak - Qualitative evaluation of a diabetes electronic decision support tool: views of users. ( 0,539835836370218 )
J. Med. Internet Res. - Overcoming Addictions, a Web-based application, and SMART Recovery, an online and in-person mutual help group for problem drinkers, part 1: three-month outcomes of a randomized controlled trial. ( 0,539361430175208 )
J. Med. Internet Res. - Changes in depressive symptoms, social support, and loneliness over 1 year after a minimum 3-month videoconference program for older nursing home residents. ( 0,539237849039069 )
Healthc (Amst) - Flexible implementation and integration of new team members to support patient-centered care. ( 0,536756428003648 )
Int J Med Inform - Closing information gaps with shared electronic patient summaries: how much will it matter? ( 0,536410863343152 )
J. Med. Internet Res. - Web-based intervention in mindfulness meditation for reducing residual depressive symptoms and relapse prophylaxis: a qualitative study. ( 0,535620832634867 )
J Telemed Telecare - Improving attendance in psychiatric outpatient clinics by using reminders. ( 0,53547477255068 )
BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments. ( 0,535422511201009 )
BMC Med Inform Decis Mak - Designing a multifaceted survivorship care plan to meet the information and communication needs of breast cancer patients and their family physicians: results of a qualitative pilot study. ( 0,535371941069744 )
BMC Med Inform Decis Mak - Speech recognition software and electronic psychiatric progress notes: physicians' ratings and preferences. ( 0,533724442739776 )
J Clin Monit Comput - The effect of atropine on the bispectral index response to endotracheal intubation during propofol and remifentanil anesthesia. ( 0,532850955110485 )