Telemed J E Health - International trauma teleconference: evaluating trauma care and facilitating quality improvement.

Tópicos

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

CKGROUND: Evaluation, development, and implementation of trauma systems in Latin America are challenging undertakings as no model is currently in place that can be easily replicated throughout the region. The use of teleconferencing has been essential in overcoming other challenges in the medical field and improving medical care. This article describes the use of international videoconferencing in the field of trauma and critical care as a tool to evaluate differences in care based on local resources, as well as facilitating quality improvement and system development in Latin America.MATERIALS AND METHODS: In February 2009, the International Trauma and Critical Care Improvement Project was created and held monthly teleconferences between U.S. trauma surgeons and Latin American general surgeons, emergency physicians, and intensivists. In-depth discussions and prospective evaluations of each case presented were conducted by all participants based on resources available. Care rendered was divided in four stages: (1) pre-hospital setting, (2) emergency room or trauma room, (3) operating room, and (4) subsequent postoperative care. Furthermore, the participating institutions completed an electronic survey of trauma resources based on World Health Organization/International Association for Trauma and Surgical Intensive Care guidelines.RESULTS: During a 17-month period, 15 cases in total were presented from a Level I and a Level II U.S. hospital (n=3) and five Latin American hospitals (n=12). Presentations followed the Advanced Trauma Life Support sequence in all U.S. cases but in only 3 of the 12 Latin American cases. The following deficiencies were observed in cases presented from Latin America: pre-hospital communication was nonexistent in all cases; pre-hospital services were absent in 60% of cases presented; lack of trauma team structure was evident in the emergency departments; during the initial evaluation and resuscitation, the Advanced Trauma Life Support protocol was followed one time and the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage protocol on two occasions; it was determined that imaging resources were adequately used in half of the cases; the initial care was mostly provided by emergency room physicians; and a surgeon, operating room, and intensive care unit were not readily available 83% of the time. The ease of patient flow was cumbersome because of a lack of a structured system for trauma care except for one academic urban center. Adequate trauma resources are present in less than 50% of the time. Multidisciplinary resources, quality improvement programs, protocols, and guidelines were deficient.CONCLUSIONS: A well-structured international teleconference can be used as a dynamic window of observation to evaluate and identify deficiencies in trauma care in the Latin American region. These findings can be used to formulate specific recommendations based on local resources. Furthermore, by raising local awareness, leaders could be identified to become the executors of more efficient healthcare policies that can potentially affect trauma care.

Resumo Limpo

ckground evalu develop implement trauma system latin america challeng undertak model current place can easili replic throughout region use teleconferenc essenti overcom challeng medic field improv medic care articl describ use intern videoconferenc field trauma critic care tool evalu differ care base local resourc well facilit qualiti improv system develop latin americamateri method februari intern trauma critic care improv project creat held month teleconfer us trauma surgeon latin american general surgeon emerg physician intensivist indepth discuss prospect evalu case present conduct particip base resourc avail care render divid four stage prehospit set emerg room trauma room oper room subsequ postop care furthermor particip institut complet electron survey trauma resourc base world health organizationintern associ trauma surgic intens care guidelinesresult month period case total present level level ii us hospit n five latin american hospit n present follow advanc trauma life support sequenc us case latin american case follow defici observ case present latin america prehospit communic nonexist case prehospit servic absent case present lack trauma team structur evid emerg depart initi evalu resuscit advanc trauma life support protocol follow one time clinic random antifibrinolyt signific hemorrhag protocol two occas determin imag resourc adequ use half case initi care most provid emerg room physician surgeon oper room intens care unit readili avail time eas patient flow cumbersom lack structur system trauma care except one academ urban center adequ trauma resourc present less time multidisciplinari resourc qualiti improv program protocol guidelin deficientconclus wellstructur intern teleconfer can use dynam window observ evalu identifi defici trauma care latin american region find can use formul specif recommend base local resourc furthermor rais local awar leader identifi becom executor effici healthcar polici can potenti affect trauma care

Resumos Similares

BMC Med Inform Decis Mak - A study of clinical and information management processes in the surgical pre-assessment clinic. ( 0,77293822108286 )
Int J Med Inform - Towards an understanding of the information dynamics of the handover process in aged care settings--a prerequisite for the safe and effective use of ICT. ( 0,740535667352874 )
BMC Med Inform Decis Mak - The status of IT service management in health care - ITIL? in selected European countries. ( 0,720765494381889 )
BMC Med Inform Decis Mak - Technical support and delegation to practice staff - status quo and (possible) future perspectives for primary health care in Germany. ( 0,694303528676505 )
Health Informatics J - Accessibility, usability, and usefulness of a Web-based clinical decision support tool to enhance provider-patient communication around Self-management TO Prevent (STOP) Stroke. ( 0,693298461150639 )
Health Informatics J - The coordination hub: Toward patient-centered and collaborative care processes. ( 0,676041127934654 )
BMC Med Inform Decis Mak - Lessons learned from implementation of computerized provider order entry in 5 community hospitals: a qualitative study. ( 0,673096913159014 )
Int J Med Inform - Health information exchange interventions can enhance quality and continuity of HIV care. ( 0,671288075325774 )
Int J Med Inform - Managing variations from surgical care plans: challenges for coordination. ( 0,653026034820537 )
J Am Med Inform Assoc - Computerized provider documentation: findings and implications of a multisite study of clinicians and administrators. ( 0,651868656855147 )
AMIA Annu Symp Proc - Clinical Workflow Observations to Identify Opportunities for Nurse, Physicians and Patients to Share a Patient-centered Plan of Care. ( 0,651359090783828 )
Perspect Health Inf Manag - Navigating regulatory change: preliminary lessons learned during the healthcare provider transition to ICD-10-CM/PCS. ( 0,64374603745875 )
Inform Health Soc Care - Information exchange between registered nurses and district nurses during the discharge planning process: cross-sectional analysis of survey data. ( 0,636044212327009 )
BMC Med Inform Decis Mak - Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study. ( 0,635148163394194 )
J Telemed Telecare - The benefit of smart phone usage in liver organ procurement. ( 0,628172066876981 )
AMIA Annu Symp Proc - Development of a nursing handoff tool: a web-based application to enhance patient safety. ( 0,627899808956489 )
Int J Med Inform - Guidelines for maternal and neonatal point of care: needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso. ( 0,624231125515283 )
Comput Methods Programs Biomed - Supporting a distributed execution of clinical guidelines. ( 0,62415295494012 )
Appl Clin Inform - A case report in health information exchange for inter-organizational patient transfers. ( 0,618875739792651 )
Healthc (Amst) - Implementing a patient centered medical home in the Veterans health administration: Perspectives of primary care providers. ( 0,6186138581435 )
Int J Med Inform - Evaluation of a comprehensive EHR based on the DeLone and McLean model for IS success: approach, results, and success factors. ( 0,616709640105647 )
J Med Syst - Intelligent analysis of acute bed overflow in a tertiary hospital in Singapore. ( 0,613610659180578 )
Med Decis Making - Are waiting list prioritization guidelines being followed in Australia? ( 0,610064965994114 )
J Am Med Inform Assoc - Quantifying care coordination using natural language processing and domain-specific ontology. ( 0,607196781934372 )
Healthc (Amst) - Doubling down: Lessons learned from building a new electronic health record as part of primary care practice redesign. ( 0,606862150568412 )
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. ( 0,606146073417403 )
BMC Med Inform Decis Mak - Redesign of a computerized clinical reminder for colorectal cancer screening: a human-computer interaction evaluation. ( 0,606095879070548 )
Telemed J E Health - Standardizing sepsis screening and management via a tele-ICU program improves patient care. ( 0,604449169922647 )
J Telemed Telecare - The effect of PACS on the practice of orthopaedic surgeons. ( 0,602850923062851 )
Int J Med Inform - Technology-mediated awareness: facilitating the handling of (un)wanted interruptions in a hospital setting. ( 0,60245448440296 )
BMC Med Inform Decis Mak - National survey focusing on the crucial information needs of intensive care charge nurses and intensivists: same goal, different demands. ( 0,602059121117707 )
Med Biol Eng Comput - Retrospective evaluation of a decision support system for controlled mechanical ventilation. ( 0,601304852142385 )
Int J Med Inform - Barriers and facilitators to the use of computer-based intensive insulin therapy. ( 0,598724257263602 )
J. Med. Internet Res. - An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study. ( 0,598702633600351 )
Appl Clin Inform - An evaluation of the usability of a computerized decision support system for nursing homes. ( 0,597905117036299 )
Methods Inf Med - An observation tool for studying patient-oriented workflow in hospital emergency departments. ( 0,59604383558342 )
J. Med. Internet Res. - Home care technology through an ability expectation lens. ( 0,595509981185928 )
J Innov Health Inform - Using information to deliver safer care: a mixed-methods study exploring general practitioners' information needs in North West London primary care. ( 0,595343481240494 )
BMC Med Inform Decis Mak - A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland. ( 0,595223901204895 )
Int J Med Inform - Telemedicine across borders: a systematic review of factors that hinder or support implementation. ( 0,593761685770043 )
Int J Med Inform - The impact of medical record technologies on collaboration in emergency medicine. ( 0,593659001927547 )
J Med Syst - Data envelopment analysis model for the appraisal and relative performance evaluation of nurses at an intensive care unit. ( 0,593635007759048 )
Telemed J E Health - Application of a smartphone nurse call system for nursing care. ( 0,591777771157139 )
BMC Med Inform Decis Mak - Quality of prenatal and maternal care: bridging the know-do gap (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa. ( 0,589277894999733 )
Int J Med Inform - The effect of computerized decision support on barriers to guideline implementation: a qualitative study in outpatient cardiac rehabilitation. ( 0,588896743378825 )
Int J Med Inform - Closing information gaps with shared electronic patient summaries: how much will it matter? ( 0,58882548542908 )
AMIA Annu Symp Proc - Knowledge crystallization and clinical priorities: evaluating how physicians collect and synthesize patient-related data. ( 0,585326025087528 )
J Biomed Inform - Computer-interpretable clinical guidelines: a methodological review. ( 0,582966204507098 )
J. Med. Internet Res. - Researchers' needs for resource discovery and collaboration tools: a qualitative investigation of translational scientists. ( 0,582209205346057 )
J Am Med Inform Assoc - MyHealthAtVanderbilt: policies and procedures governing patient portal functionality. ( 0,579086673509233 )
J Am Med Inform Assoc - A patient-centered longitudinal care plan: vision versus reality. ( 0,57524832253772 )
Int J Med Inform - Does e-pain plan improve management of sickle cell disease associated vaso-occlusive pain crisis? a mixed methods evaluation. ( 0,574815223193454 )
J. Med. Internet Res. - Clinicians' expectations of Web 2.0 as a mechanism for knowledge transfer of stroke best practices. ( 0,574026547953847 )
Telemed J E Health - A systematic review of clinician and staff views on the acceptability of incorporating remote monitoring technology into primary care. ( 0,573018221482433 )
J Am Med Inform Assoc - Physicians' opinions of a health information exchange. ( 0,572199189181705 )
AMIA Annu Symp Proc - Developing nursing computer interpretable guidelines: a feasibility study of heart failure guidelines in homecare. ( 0,571481378738733 )
J Med Syst - Understanding critical barriers to implementing a clinical information system in a nursing home through the lens of a socio-technical perspective. ( 0,571327100284539 )
Comput Methods Programs Biomed - LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS) in Swaziland, Africa - a qualitative study. ( 0,570668336520424 )
J Am Med Inform Assoc - Chart biopsy: an emerging medical practice enabled by electronic health records and its impacts on emergency department-inpatient admission handoffs. ( 0,570664073735008 )
Int J Med Inform - Use of web-based patient education sessions on psychiatric wards. ( 0,569926195892632 )
BMC Med Inform Decis Mak - Prescriber and staff perceptions of an electronic prescribing system in primary care: a qualitative assessment. ( 0,569763350393637 )
Perspect Health Inf Manag - The impact of health literacy on a patient's decision to adopt a personal health record. ( 0,569608133909258 )
J Am Med Inform Assoc - Patient-centered care requires a patient-oriented workflow model. ( 0,568622687933732 )
J Telemed Telecare - Managing suicidality in home-based telehealth. ( 0,568194152642628 )
J Med Syst - Advanced nurse-patient communication system. ( 0,567766333800411 )
Appl Clin Inform - CAH to CAH: EHR implementation advice to critical access hospitals from peer experts and other key informants. ( 0,564155950114608 )
BMC Med Inform Decis Mak - Development of a prototype clinical decision support tool for osteoporosis disease management: a qualitative study of focus groups. ( 0,563269929097524 )
Int J Med Inform - Going paperless at the emergency department: a socio-technical study of an information system for patient tracking. ( 0,562157428671819 )
BMC Med Inform Decis Mak - Implementation of an integrated preoperative care pathway and regional electronic clinical portal for preoperative assessment. ( 0,561998387081148 )
Int J Med Inform - Coping with the unforeseen in surgical work. ( 0,559318432517304 )
J Biomed Inform - Bridging gaps in handoffs: a continuity of care based approach. ( 0,559217287468574 )
AMIA Annu Symp Proc - Cognitive design of a digital desk for the emergency room setting. ( 0,559082953182039 )
J Am Med Inform Assoc - Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness. ( 0,559062922172024 )
Int J Med Inform - The use of technology for urgent clinician to clinician communications: a systematic review of the literature. ( 0,557795538455883 )
Int J Med Inform - Does an integrated Emergency Department Information System change the sequence of clinical work? A mixed-method cross-site study. ( 0,557553460323173 )
BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments. ( 0,55660401743169 )
J Telemed Telecare - An economic analysis of a nurse-led telephone triage service. ( 0,556514813696884 )
Int J Med Inform - The importance of the verbal shift handover report: a multi-site case study. ( 0,556437003387592 )
J Am Med Inform Assoc - A system dynamics evaluation model: implementation of health information exchange for public health reporting. ( 0,553459180670577 )
J Med Syst - Mobile technology use in medical education. ( 0,552762386562449 )
Telemed J E Health - Communication strategies and timeliness of response to life critical telemetry alarms. ( 0,552672337980145 )
BMC Med Inform Decis Mak - Participatory eHealth development to support nurses in antimicrobial stewardship. ( 0,55263811124029 )
BMC Med Inform Decis Mak - What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study. ( 0,552059189980655 )
Appl Clin Inform - Lessons learned for collaborative clinical content development. ( 0,549969751116197 )
Health Informatics J - Increased electronic information sharing by sexual health services: confidentiality and consent. ( 0,549867805519757 )
J Am Med Inform Assoc - Content and functional specifications for a standards-based multidisciplinary rounding tool to maintain continuity across acute and critical care. ( 0,549709051229341 )
Int J Med Inform - Perceptions of urgency: defining the gap between what physicians and nurses perceive to be an urgent issue. ( 0,54929794430197 )
Int J Med Inform - Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow. ( 0,549255064746629 )
Methods Inf Med - It's time for health record banking! ( 0,549146530827283 )
AMIA Annu Symp Proc - Extending the GuideLine Implementability Appraisal (GLIA) instrument to identify problems in control flow. ( 0,547825446000571 )
Inform Health Soc Care - The importance of interaction in the implementation of information technology in health care: a symbolic interactionism study on the meaning of accessibility. ( 0,547811520043745 )
J Am Med Inform Assoc - Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use. ( 0,547625049179144 )
J. Med. Internet Res. - Perceived barriers and facilitators of using a Web-based interactive decision aid for colorectal cancer screening in community practice settings: findings from focus groups with primary care clinicians and medical office staff. ( 0,54681887163029 )
Int J Med Inform - Impact of IT-supported clinical pathways on medical staff satisfaction. A prospective longitudinal cohort study. ( 0,546221575874328 )
Int J Med Inform - From clinical practice guidelines, to clinical guidance in practice - impacts for computerization. ( 0,545931628286595 )
Int J Med Inform - Use of electronic information systems in nursing management. ( 0,545174068221577 )
AMIA Annu Symp Proc - Examining the Multi-level Fit between Work and Technology in a Secure Messaging Implementation. ( 0,54386042972458 )
Int J Med Inform - Instant messaging at the hospital: supporting articulation work? ( 0,543625441135047 )
AMIA Annu Symp Proc - Falling through the cracks: information breakdowns in critical care handoff communication. ( 0,543373307212848 )
Int J Med Inform - Preparing the ground for the 'paperless hospital': a case study of medical records management in a UK outpatient services department. ( 0,54268326389708 )