scholarly journals Electronic medical record in cardiology: a 10-year Italian experience

2015 ◽  
Vol 61 (4) ◽  
pp. 317-323
Author(s):  
Clara Carpeggiani ◽  
Alberto Macerata ◽  
Maria Aurora Morales
Keyword(s):  
Health Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
System Integration ◽  
Health Care Quality ◽  
Care Center ◽  
Health Care Organization ◽  
Tertiary Care ◽  
Care Quality ◽  
Care Organization

SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR) use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals). EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

scholarly journals Use of more than one electronic medical record system within a single health care organization

2012 ◽  
Vol 03 (04) ◽  
pp. 462-474 ◽  
Author(s):  
J. Fellner ◽  
C. Dugowson ◽  
D. Liebovitz ◽  
G. Fletcher ◽  
T. Payne
Keyword(s):  
Health Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Health Care Organization ◽  
Electronic Medical Record System ◽  
Healthcare Organization ◽  
Care Organization ◽  
Data Types ◽  
Record System ◽  
Medical Record System

SummaryHealthcare organizations vary in the number of electronic medical record (EMR) systems they use. Some use a single EMR for nearly all care they provide, while others use EMRs from more than one vendor. These strategies create a mixture of advantages, risks and costs. Based on our experience in two organizations over a decade, we analyzed use of more than one EMR within our two health care organizations to identify advantages, risks and costs that use of more than one EMR presents. We identified the data and functionality types that pose the greatest challenge to patient safety and efficiency. We present a model to classify patterns of use of more than one EMR within a single healthcare organization, and identified the most important 28 data types and 4 areas of functionality that in our experience present special challenges and safety risks with use of more than one EMR within a single healthcare organization. The use of more than one EMR in a single organization may be the chosen approach for many reasons, but in our organizations the limitations of this approach have also become clear. Those who use and support EMRs realize that to safely and efficiently use more than one EMR, a considerable amount of IT work is necessary. Thorough understanding of the challenges in using more than one EMR is an important prerequisite to minimizing the risks of using more than one EMR to care for patients in a single healthcare organization. Citation: Payne T, Fellner J, Dugowson C, Liebovitz D, Fletcher G. Use of more than one electronic medical record system within a single health care organization. Appl Clin Inf 2012; 3: 462–474http://dx.doi.org/10.4338/ACI-2012-10-RA-0040

scholarly journals Impact of the COVID-19 Pandemic on the Hospital: Inpatient’s Perceived Quality in Spain

2021 ◽  
Vol 8 ◽  
pp. 237437352199862
Author(s):  
Julio J Lopez-Picazo ◽  
Inmaculada Vidal-Abarca ◽  
Dolores Beteta ◽  
Mercedes López-Ibáñez ◽  
Elisa García-Vázquez
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Health Care Organization ◽  
Perceived Quality ◽  
Care Quality ◽  
Point Of View ◽  
Care Organization ◽  
Perceived Quality Of Care ◽  
Ethical Approval

Although the Coronavirus disease 2019 (COVID-19) pandemic has generated a large amount of studies, the patient-perceived quality of care (PQ) in this context is still not well known, so more studies intending to focus on this issue are strongly needed. This study assesses changes on PQ in patients hospitalized in Spain during the first month of the COVID-19 pandemic and investigates differences between those admitted for this cause and the rest a descriptive study using the “Net Promoters Score” and the hospital regular monitoring plan. Due to this point of view, ethical approval is not applicable. Four PQ dimensions (nurse, physician, and nurse assistant actions [NA], and discharge information [DI]) were measured in all COVID patients (57) and in a sample of non-COVID patients (60) discharged at home during the first month of the pandemic, and also compared with another sample (384) from an immediately previous period. The COVID patients scored worse (8.2) than non-COVID ones (9.0; P < .0001), especially in NA and DI, and were more likely to be detractors (odds ratio [OR]: 3.05, P < .0001) and less to be promoters (OR: 0.64, P < .05). Global and DI net promoters score values before the pandemic were higher than afterward. In conclusion, the COVID-19 pandemic negatively and significantly influenced the health care quality as perceived by inpatients, both in COVID and in non-COVID ones, but more intensely in the former. As a health care organization, this knowledge meant an opportunity from improvement and to be better qualified to face the pandemic.

Quality improvement in large healthcare organizations

2016 ◽  
Vol 30 (1) ◽  
pp. 133-153 ◽  
Author(s):  
Elisabet Höög ◽  
Jack Lysholm ◽  
Rickard Garvare ◽  
Lars Weinehall ◽  
Monica Elisabeth Nyström
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Care Quality ◽  
Health Care Systems ◽  
Care Quality ◽  
Care Organization ◽  
Longitudinal Case Study ◽  
Systematic Analysis ◽  
Content Type

Purpose – The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. Design/methodology/approach – A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings – The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications – A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization’s measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value – Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor’s view on important factors to consider when building a coherent organizational M & F strategy.

scholarly journals Including Language Access into Medicaid ACO Design

2016 ◽  
Vol 44 (3) ◽  
pp. 492-502
Author(s):  
Rachel Gershon ◽  
Lisa Morris ◽  
Warren Ferguson
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Cost Of Care ◽  
Care Organization ◽  
Accountable Care ◽  
Language Access ◽  
Language Services ◽  
Payment Methods

Quality health care relies upon communication in a patient's preferred language. Language access in health care occurs when individuals are: (1) Welcomed by providers regardless of language ability; and (2) Offered quality language services as part of their care. Federal law generally requires access to health care and quality language services for deaf and Limited English Proficient (LEP) patients in health care settings, but these patients still find it hard to access health care and quality language services.Meanwhile, several states are implementing Medicaid Accountable Care Organization (ACO) initiatives to reduce health care costs and improve health care quality. Alternative payment methods used in these initiatives can give Accountable Care Organizations more flexibility to design linguistically accessible care, but they can also put ACOs at increased financial risk for the cost of care. If these new payment methods do not account for differences in patient language needs, ACO initiatives could have the unintended consequence of rewarding ACOs who do not reach out to deaf and LEP communities or offer quality language services.We reviewed public documents related to Medicaid ACO initiatives in six states. Some of these documents address language access. More could be done, however, to pay for language access efforts. This article describes Medicaid ACO initiatives and explores how different payment tools could be leveraged to reward ACOs for increased access to care and quality language services. We find that a combination of payment tools might be helpful to encourage both access and quality.

Healthcare quality through the eyes of bloggers: content analysis of non-solicited narratives about patient experiences with healthcare (Preprint)

2021 ◽  
Author(s):  
Mátyás Osváth ◽  
Orsolya Varga ◽  
Karolina Kósa
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Health Care Quality ◽  
Qualitative Content Analysis ◽  
Tertiary Care ◽  
Healthcare Quality ◽  
Patient Experiences ◽  
Care Quality ◽  
Patient Reports ◽  
Patient Narratives

BACKGROUND Patient experiences constitute an independent dimension of health care quality that can be solicited by structured surveys or at dedicated online platforms. Unsolicited spontaneous patient narratives are much less used but potentially valuable means for gauging patient experiences. OBJECTIVE Our aim was to explore patient experiences in spontaneous patient blogs submitted during one decade to an online health forum. METHODS 1662 non-solicited individual blogs on patient experiences posted between 2009 and 2018 on a Hungarian internet forum were randomly sampled. 20% (n=346) of the blogs were used for qualitative content analysis. A coding framework was constructed based on previous research and taxonomies to analyse content, including specific experiences or episodes. Major categories and subcategories were constructed within the three major dimensions (structure, process, outcome) of Donabedian’s framework for health care quality. RESULTS Majority of blogs described a specific experience (94.2%) in healthcare; almost 40% occurred in tertiary care; 29.5% of the blogs even identified a specific hospital or department. 55.2% of the bloggers were patients themselves, and the majority (92.7%) were dissatisfied with the reported experience. Issues were most frequently related to physicians (65.2%). In terms of Donabedian’s dimensions, problems with human resources dominated “Structure” (74.1%) such as not enough or incompetent staff. Waiting time and access to care (69.19%) comprised the most frequent complaints of material resources within “Structure”. Within “Process”, episodes related to examination (42.86%) accounted for most of the complaints. Outcomes were identified in 60% of the blogs, and deterioration, complication, readmission, or death was reported in 62% of these episodes. CONCLUSIONS Donabedian’s model of healthcare quality was appropriate for the categorization of patient experiences. Regular monitoring of spontaneous patient reports is recommended to utilize them for healthcare quality improvement especially if reports provide specific details.

scholarly journals Leveraging the Electronic Medical Record to Identify Patients at Risk of Antibiotic Resistant Organisms

2020 ◽  
Vol 41 (S1) ◽  
pp. s313-s313
Author(s):  
Jenna Rasmusson ◽  
Jean Barth ◽  
Sarah Bellows Mahler ◽  
Debra Apenhorst ◽  
Mary Dalton ◽  
...  
Keyword(s):  
At Risk ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Care Center ◽  
Tertiary Care ◽  
The United States ◽  
Similar Process ◽  
Infection Prevention And Control ◽  
Emerging Infections ◽  
Patients At Risk

Background: Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) pose a serious public health threat. The CDC guidelines for combating CP-CRE include a recommendation to screen selected high-risk patients. Objective: We describe a program to identify and screen patients at risk for CP-CRE. Setting: An academic, tertiary-care center with 1,297 licensed beds and 62,071 admissions per year. Methods: A report was created in the electronic medical record (EMR) to identify adult patients admitted in the previous 24 hours from countries and states with known CP-CRE transmission based on address and ZIP code. Patients with a known travel history outside the United States were also reviewed, but these data were inaccurate. Initially, a physician from Infection Prevention and Control (IPAC) placed orders for CP-CRE screening of these patients. Subsequently, a nursing protocol was developed to facilitate infection preventionists placing orders for CP-CRE screening earlier in the eligible patient’s hospital stay. An electronic communication is sent via the EMR alerting the patient care team to the order, the rationale for the order, and links to a tool kit with resources to help answer patient questions. A single perirectal swab is obtained by the nurse caring for the patient and is tested for Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), oxacillinase-48 (OXA-48), and Verona integron-encoded metallo-β-lactamase (VIM) by polymerase chain reaction (PCR). Results: From May 2018 to November 2019, 688 patients were screened for CP-CRE using the case-finding report and the nursing protocol. Overall, 9 patients with CP-CRE were identified: 1 KPC, 2 NDM, and 5 OXA-48, and 1 patient was identified to have both NDM and OXA-48. The yield of 1.3% from this screening is higher than that reported previously in the literature. Use of the nursing protocol has enabled IPAC to complete timely CP-CRE surveillance and prevent transmission to other patients. We are currently using a similar process to identify and screen persons at risk for the emerging infection Candida auris.Conclusions: The EMR can be leveraged for early identification and screening of patients with epidemiologically significant pathogens. Protocols within the EMR can be effectively replicated and modified to respond to emerging infections and changing surveillance guidelines.Funding: NoneDisclosures: Consulting fee-—Merck (Priya Sampathkumar)

Benchmarking of the Maintenance Service in Health Care Organizations

2017 ◽  
pp. 1-25
Author(s):  
María Carmen Carnero
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Health Care Organization ◽  
Care Quality ◽  
Care Staff ◽  
Care Organization ◽  
Analytic Hierarchy ◽  
Maintenance Service ◽  
Hierarchy Process

The support services of health care organizations, such as maintenance, have not traditionally been considered important from the perspective of care quality. Nevertheless, the degree of excellence in maintenance significantly influences availability, maintenance costs and safety of facilities, medical equipment, patients and care staff. Thus, it would be of great importance for health care organizations to apply benchmarking to their maintenance processes, as do other processing companies, in order to determine the quality of maintenance provided, and compare it to other, similar, organizations. This would also allow all the continuous improvement processes to be controlled, and actions for radical improvement to be carried out by comparing performance with that of companies in other sectors. This chapter describes a multicriteria model integrating a fuzzy Analytic Hierarchy Process with utility theory to obtain a valuation for the Maintenance Service of a Health Care Organization over time.

Patient satisfaction and brand loyalty in health-care organizations in India

2017 ◽  
Vol 11 (1) ◽  
pp. 73-87 ◽  
Author(s):  
Vinay Sharma
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Management ◽  
Conceptual Model ◽  
Health Care Quality ◽  
Care Quality ◽  
Care Organization ◽  
Total Quality ◽  
Content Type ◽  
New Instrument

Purpose This paper aims to examine the major factors affecting patients’ satisfaction and loyalty at a health-care organization in India. Design/methodology/approach A conceptual model has been developed that includes the behavioural dimensions of total quality management (TQM), patient satisfaction and loyalty. This study is exploratory in nature and has used the existing literature to build the conceptual model. Findings A solution for improving the quality of health-care services can be found in the application of total relationship management and TQM, together with a customer orientation strategy. Practical implications The results can be used creatively by hospitals to re-engineer and redesign their quality management processes and reorient the future directions of their more effective health-care quality strategies. Originality/value In this research, a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented.

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