BMC Med Inform Decis Mak - Detecting and diagnosing hotspots for the enhanced management of hospital Emergency Departments in Queensland, Australia.

Tópicos

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

Resumo

CKGROUND: Predictive tools are already being implemented to assist in Emergency Department bed management by forecasting the expected total volume of patients. Yet these tools are unable to detect and diagnose when estimates fall short. Early detection of hotspots, that is subpopulations of patients presenting in unusually high numbers, would help authorities to manage limited health resources and communicate effectively about emerging risks. We evaluate an anomaly detection tool that signals when, and in what way Emergency Departments in 18 hospitals across the state of Queensland, Australia, are significantly exceeding their forecasted patient volumes.METHODS: The tool in question is an adaptation of the Surveillance Tree methodology initially proposed in Sparks and Okugami (IntStatl 1:2-24, 2010). for the monitoring of vehicle crashes. The methodology was trained on presentations to 18 Emergency Departments across Queensland over the period 2006 to 2008. Artificial increases were added to simulated, in-control counts for these data to evaluate the tool's sensitivity, timeliness and diagnostic capability. The results were compared with those from a univariate control chart. The tool was then applied to data from 2009, the year of the H1N1 (or 'Swine Flu') pandemic.RESULTS: The Surveillance Tree method was found to be at least as effective as a univariate, exponentially weighted moving average (EWMA) control chart when increases occurred in a subgroup of the monitored population. The method has advantages over the univariate control chart in that it allows for the monitoring of multiple disease groups while still allowing control of the overall false alarm rate. It is also able to detect changes in the makeup of the Emergency Department presentations, even when the total count remains unchanged. Furthermore, the Surveillance Tree method provides diagnostic information useful for service improvements or disease management.CONCLUSIONS: Multivariate surveillance provides a useful tool in the management of hospital Emergency Departments by not only efficiently detecting unusually high numbers of presentations, but by providing information about which groups of patients are causing the increase.

Resumo Limpo

ckground predict tool alreadi implement assist emerg depart bed manag forecast expect total volum patient yet tool unabl detect diagnos estim fall short earli detect hotspot subpopul patient present unusu high number help author manag limit health resourc communic effect emerg risk evalu anomali detect tool signal way emerg depart hospit across state queensland australia signific exceed forecast patient volumesmethod tool question adapt surveil tree methodolog initi propos spark okugami intstatl monitor vehicl crash methodolog train present emerg depart across queensland period artifici increas ad simul incontrol count data evalu tool sensit timeli diagnost capabl result compar univari control chart tool appli data year hn swine flu pandemicresult surveil tree method found least effect univari exponenti weight move averag ewma control chart increas occur subgroup monitor popul method advantag univari control chart allow monitor multipl diseas group still allow control overal fals alarm rate also abl detect chang makeup emerg depart present even total count remain unchang furthermor surveil tree method provid diagnost inform use servic improv diseas managementconclus multivari surveil provid use tool manag hospit emerg depart effici detect unusu high number present provid inform group patient caus increas

Resumos Similares

BMC Med Inform Decis Mak - Relationship between the population incidence of pertussis in children in New South Wales, Australia and emergency department visits with cough: a time series analysis. ( 0,743409255454557 )
Appl Clin Inform - A Computerized Alert Screening for Severe Sepsis in Emergency Department Patients Increases Lactate Testing but does not Improve Inpatient Mortality. ( 0,65466396667786 )
J Med Syst - Variability of subspecialty-specific anesthesia-controlled times at two academic institutions. ( 0,645573987768078 )
BMC Med Inform Decis Mak - Real-time automatic hospital-wide surveillance of nosocomial infections and outbreaks in a large Chinese tertiary hospital. ( 0,638575789218812 )
Int J Med Inform - Effects of a short text message reminder system on emergency department length of stay. ( 0,636815944871712 )
J Telemed Telecare - A pilot project for improving paediatric diabetes outcomes using a website: the Pediatric Diabetes Education Portal. ( 0,635346913009596 )
J. Med. Internet Res. - Online social network use by health care providers in a high traffic patient care environment. ( 0,634530071571171 )
J. Med. Internet Res. - Clinical outcome and cost-effectiveness of a synchronous telehealth service for seniors and nonseniors with cardiovascular diseases: quasi-experimental study. ( 0,632247517304307 )
Int J Med Inform - Prospective pilot study of a tablet computer in an Emergency Department. ( 0,628976989636266 )
J Am Med Inform Assoc - Patient reported barriers to enrolling in a patient portal. ( 0,628131318384192 )
Telemed J E Health - Hot spot: impact of July 2011 heat wave in southern Italy (Apulia) on cardiovascular disease assessed by emergency medical service and telemedicine support. ( 0,623919827555979 )
Int J Med Inform - Effects of electronic medical record in a Chinese hospital: a time series study. ( 0,622050303383025 )
Telemed J E Health - Is telemedicine an answer to reducing 30-day readmission rates post-acute myocardial infarction? ( 0,620292765840716 )
J. Med. Internet Res. - Assessment of the cost-effectiveness and clinical outcomes of a fourth-generation synchronous telehealth program for the management of chronic cardiovascular disease. ( 0,61549405923031 )
Telemed J E Health - Emergency department physician telemedical triage. ( 0,599370424724298 )
Int J Med Inform - The positive financial impact of using an Intensive Care Information System in a tertiary Intensive Care Unit. ( 0,59154411718765 )
J. Med. Internet Res. - Importance of Internet surveillance in public health emergency control and prevention: evidence from a digital epidemiologic study during avian influenza A H7N9 outbreaks. ( 0,59045275857673 )
J Telemed Telecare - A longitudinal study of health service utilization for diabetes patients in a care coordination home-telehealth programme. ( 0,58887311098518 )
J Telemed Telecare - Evaluation of a telemedical care programme for patients with Parkinson's disease. ( 0,586727864431625 )
J. Med. Internet Res. - Impact of health portal enrollment with email reminders on adherence to clinic appointments: a pilot study. ( 0,584183757071003 )
Telemed J E Health - Robotic telepresence versus standardly supervised stroke alert team assessments. ( 0,584013671011928 )
Telemed J E Health - Clinical and economic impact of remote monitoring on the follow-up of patients with implantable electronic cardiovascular devices: an observational study. ( 0,583190391628821 )
J. Med. Internet Res. - A novel evaluation of World No Tobacco day in Latin America. ( 0,580687748755092 )
J Am Med Inform Assoc - Effectiveness of an automated surveillance system for intensive care unit-acquired infections. ( 0,575270253281369 )
J Am Med Inform Assoc - The hazard of software updates to clinical workstations: a natural experiment. ( 0,572529722925187 )
Comput. Biol. Med. - Recurring patterns of atrial fibrillation in surface ECG predict restoration of sinus rhythm by catheter ablation. ( 0,571375616213232 )
Comput. Biol. Med. - Sensitivity analysis of state-transition models: how to deal with a large number of inputs. ( 0,571015577586974 )
Appl Clin Inform - Healthcare Information Systems to Assess Influenza Outbreaks: An analysis of the 2009 H1N1 Epidemic in Buenos Aires. ( 0,570582326789807 )
J Telemed Telecare - Spanish-speaking patients' engagement in interactive voice response (IVR) support calls for chronic disease self-management: data from three countries. ( 0,570085430934704 )
J Telemed Telecare - Utilization of home telemonitoring in patients 75 years of age and over with complex heart failure. ( 0,569198766653552 )
Healthc (Amst) - Effects of implementing a protocol for arterial blood gas use on ordering practices and diagnostic yield. ( 0,568497895128258 )
J Telemed Telecare - A pilot trial of telemedicine-assisted, integrated care for patients with advanced amyotrophic lateral sclerosis and their caregivers. ( 0,567780247176816 )
J Med Syst - Impact of technological innovation on a nursing home performance and on the medication-use process safety. ( 0,567564525014365 )
Telemed J E Health - Detection of asymptomatic paroxysmal atrial fibrillation with the trans-telephonic electrocardiograph system. ( 0,566173007412156 )
Telemed J E Health - Home-based preventative care in high-risk dialysis patients: a pilot study. ( 0,566151807676007 )
Comput Math Methods Med - Risk factors for mortality among 2009 A/H1N1 influenza hospitalizations in Maricopa County, Arizona, April 2009 to March 2010. ( 0,562955818274563 )
BMC Med Inform Decis Mak - Is increasing complexity of algorithms the price for higher accuracy? virtual comparison of three algorithms for tertiary level management of chronic cough in people living with HIV in a low-income country. ( 0,555728637392254 )
J Clin Monit Comput - Noninvasive assessment of peripheral microcirculation by near-infrared spectroscopy: a comparative study in healthy smoking and nonsmoking volunteers. ( 0,55216762247018 )
Int J Med Inform - The absence of longitudinal data limits the accuracy of high-throughput clinical phenotyping for identifying type 2 diabetes mellitus subjects. ( 0,550465208465036 )
BMC Med Inform Decis Mak - A flexible simulation platform to quantify and manage emergency department crowding. ( 0,550264764634096 )
J Telemed Telecare - A telepsychiatry transition clinic: the first 12 months experience. ( 0,550057385552124 )
BMC Med Inform Decis Mak - Summary of data reported to CDC's national automated biosurveillance system, 2008. ( 0,550015204306134 )
J Telemed Telecare - Costs and benefits of tele-endoscopy clinics in a remote location. ( 0,549776696365106 )
Int J Med Inform - Improving hospital bed utilisation through simulation and optimisation: with application to a 40% increase in patient volume in a Norwegian General Hospital. ( 0,548873689053796 )
Comput Methods Programs Biomed - Influenza vaccination and reduction in risk of ischemic heart disease among chronic obstructive pulmonary elderly. ( 0,54548048040776 )
Med Decis Making - Patient time costs associated with sensor-augmented insulin pump therapy for type 1 diabetes: results from the STAR 3 randomized trial. ( 0,543213318376052 )
J Clin Monit Comput - Electrocardiogram characteristics prior to in-hospital cardiac arrest. ( 0,542737732724475 )
Med Decis Making - Are waiting list prioritization guidelines being followed in Australia? ( 0,542616661569985 )
BMC Med Inform Decis Mak - A predictive model for the early identification of patients at risk for a prolonged intensive care unit length of stay. ( 0,541255186555068 )
Int J Med Inform - Use of web-based patient education sessions on psychiatric wards. ( 0,539813421254241 )
J. Med. Internet Res. - Guess who's not coming to dinner? Evaluating online restaurant reservations for disease surveillance. ( 0,538842300635691 )
J Am Med Inform Assoc - Use of electronic clinical documentation: time spent and team interactions. ( 0,538674501156068 )
J Clin Monit Comput - Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation. ( 0,538356517752606 )
Int J Med Robot - Novel computer-assisted preoperative planning system for humeral shaft fractures: report of 43 cases. ( 0,537812558562254 )
J. Med. Internet Res. - Daily collection of self-reporting sleep disturbance data via a smartphone app in breast cancer patients receiving chemotherapy: a feasibility study. ( 0,536532645750554 )
BMC Med Inform Decis Mak - Development of ClickClinica: a novel smartphone application to generate real-time global disease surveillance and clinical practice data. ( 0,534624136208142 )
J Am Med Inform Assoc - A novel clinician interface to improve clinician access to up-to-date genetic results. ( 0,53212107238981 )
J. Med. Internet Res. - An analysis of online evaluations on a physician rating website: evidence from a German public reporting instrument. ( 0,530922354798096 )
Med Decis Making - Modeling the Effect of Herd Immunity and Contagiousness in Mitigating a Smallpox Outbreak. ( 0,530592340636614 )
Telemed J E Health - Improved access and cycle time with an in-house patient-centered teleglaucoma program versus traditional in-person assessment. ( 0,529266229438227 )
Health Informatics J - Development and refinement of new statistical methods for enhanced syndromic surveillance during the 2012 Olympic and Paralympic Games. ( 0,528763351493356 )
Int J Med Inform - Evaluation of the effect of information integration in displays for ICU nurses on situation awareness and task completion time: A prospective randomized controlled study. ( 0,527695311397151 )
Int J Health Geogr - Influence of satellite-derived rainfall patterns on plague occurrence in northeast Tanzania. ( 0,527390934076443 )
Spat Spatiotemporal Epidemiol - Incorporating retrospective clustering into a prospective Cusum methodology for anthrax: evaluating the effects of disease expectation. ( 0,527013047678122 )
Med Biol Eng Comput - Recurring patterns in stationary intervals of abdominal uterine electromyograms during gestation. ( 0,526627402338735 )
Int J Med Inform - The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments. ( 0,526604374483729 )
J Telemed Telecare - Telemedicine for retinal care in developing nations: the ORBIS Cyber-Sight programme, 2003-2011. ( 0,520945713336273 )
J Clin Monit Comput - The effect of preoperative consumption of potatoes on succinylcholine-induced block and recovery from anesthesia. ( 0,519180637207694 )
J Telemed Telecare - Using telemonitoring to construct knowledge about homebound patient populations: vital-signs alert rates. ( 0,515793889608369 )
Int J Health Geogr - Novel measurement of spreading pattern of influenza epidemic by using weighted standard distance method: retrospective spatial statistical study of influenza, Japan, 1999-2009. ( 0,515788415906671 )
Appl Clin Inform - Patient no-show predictive model development using multiple data sources for an effective overbooking approach. ( 0,514800732893929 )
Int J Med Robot - Frameless stereotactic targeting devices: technical features, targeting errors and clinical results. ( 0,514658522661516 )
J Biomed Inform - Method selection and adaptation for distributed monitoring of infectious diseases for syndromic surveillance. ( 0,514606234987784 )
J Clin Monit Comput - Near real-time notification of gaps in cuff blood pressure recordings for improved patient monitoring. ( 0,51376675220637 )
J Clin Monit Comput - Transcutaneous continuous carbon dioxide tension monitoring reduced incidence, degree and duration of hypercapnia during combined regional anaesthesia and monitored anaesthesia care in shoulder surgery patients. ( 0,512292232943743 )
J Telemed Telecare - A hybrid approach to telepathology in Cambodia. ( 0,512186406379632 )
J Am Med Inform Assoc - Patient characteristics associated with venous thromboembolic events: a cohort study using pooled electronic health record data. ( 0,511082116794447 )
Telemed J E Health - Development of a telehealthcare decision support system for patients discharged from the hospital. ( 0,510964547203296 )
Comput. Biol. Med. - Quantification of the acute effect of a low dose of red wine by nonlinear measures of RR and QT interval series in healthy subjects. ( 0,510249066785735 )
Int J Med Inform - Implementation of computerized provider order entry in a neonatal intensive care unit: Impact on admission workflow. ( 0,508735265401305 )
Int J Med Robot - Totally robotic right colectomy: a preliminary case series and an overview of the literature. ( 0,50797928227244 )
Telemed J E Health - Streamlining HIV testing in the emergency department-leveraging kiosks to provide true universal screening: a usability study. ( 0,507790197744332 )
Telemed J E Health - New hospital telemedicine services: potential market for a nighttime telehospitalist service. ( 0,507494310859554 )
Med Biol Eng Comput - Asymmetric properties of long-term and total heart rate variability. ( 0,507473148170675 )
Int J Med Robot - Robot-assisted adrenalectomy: a technical option for the surgeon? ( 0,507412596393947 )
AMIA Annu Symp Proc - All health care is not local: an evaluation of the distribution of Emergency Department care delivered in Indiana. ( 0,506848976597973 )
J Telemed Telecare - Non-response in telephone surveys of COPD patients does not introduce bias. ( 0,505493720568894 )
AMIA Annu Symp Proc - Cloudwave: distributed processing of big data from electrophysiological recordings for epilepsy clinical research using Hadoop. ( 0,504813435602877 )
J. Med. Internet Res. - Stroke experiences in weblogs: a feasibility study of sex differences. ( 0,502584536373936 )
J Am Med Inform Assoc - Using administrative medical claims data to supplement state disease registry systems for reporting zoonotic infections. ( 0,502500418002852 )
Med Decis Making - Health care costs for state transition models in prostate cancer. ( 0,502182292341356 )
J Telemed Telecare - A pilot study of a tool to stimulate physical activity in patients with COPD or type 2 diabetes in primary care. ( 0,501997900671487 )
J Telemed Telecare - Early text page alarms sent to cardiologists reduce door-to-balloon times in ST-elevation myocardial infarction. ( 0,501272868811878 )
J. Med. Internet Res. - Patients' continuing use of an online health record: a quantitative evaluation of 14,000 patient years of access data. ( 0,500773666984267 )
AMIA Annu Symp Proc - Implementation of a platform dedicated to the biomedical analysis terminologies management. ( 0,499973502587012 )
Int J Med Inform - Implementation and evaluation of an integrated computerized asthma management system in a pediatric emergency department: a randomized clinical trial. ( 0,499412213042748 )
Lifetime Data Anal - Combined survival analysis of cardiac patients by a Cox PH model and a Markov chain. ( 0,497511140348742 )
J Telemed Telecare - The effect of real-time teleconsultations between hospital-based nurses and patients with severe COPD discharged after an exacerbation. ( 0,497410661793147 )
J Telemed Telecare - Factors affecting frequency of patient use of Internet-based telemedicine to manage cardiovascular disease risk. ( 0,497300584242264 )
Med Decis Making - Time lost by driving fast in the United States. ( 0,496699498372385 )