Impact of a new electronic handover system in surgery
Impact of a new electronic handover system in surgery
复制标题
DOI：
10.1016/j.ijsu.2010.11.012
复制
发表时间：
2011-01-01
影响因子：
15.3
通讯作者：
Ridgway, P. F.
中科院分区：
文献类型：
--
作者：
Ryan, S.;O'Riordan, J. M.;Ridgway, P. F.
准确的临床信息交接对于确保患者护理的连续性、患者安全和减少临床错误至关重要。口头和书面的交接在许多机构中是常见的做法，但潜在的临床错误和低效率是显著的。我们最近引入了电子模板签到，以提高术后患者详细信息转移的清晰度。本研究的目的是前瞻性审计在我们医院引入这种新的电子交接，特别强调疗效和效率。选择评估疗效和效率的主要替代指标是通过急诊科入院的患者的住院时间。为了做到这一点，我们比较了引入这种新的电子签到格式之前和之后两个单独的两周时间。用户没有被告知这项研究。在签到表上记录的信息包括急诊入院的详细情况、随叫随到的咨询以及与住院病人有关的任何问题。同时记录ASA分级、首次干预时间及入院诊断。我们的研究结果表明，引入这种电子签到可以显著减少住院时间的中位数，从5天减少到4天（P = 0.047）。ASA分级、首次干预时间或总体入院诊断在两个时间段间无显著差异。总之，这是第一个研究表明，与以前使用的纸质交接相比，电子签到的引入与患者住院时间的显著缩短有关，并提供了更好的护理连续性。(C) 2010外科联合有限公司Elsevier Ltd.出版。版权所有。
Accurate handover of clinical information is imperative to ensure continuity of patient care, patient safety and reduction in clinical errors. Verbal and paper-based handovers are common practice in many institutions but the potential for clinical errors and inefficiency is significant. We have recently introduced an electronic templated signout to improve clarity of transfer of patient details post-surgical take.The aim of this study was to prospectively audit the introduction of this new electronic handover in our hospital with particular emphasis regarding efficacy and efficiency. The primary surrogate chosen to assess efficacy and efficiency was length of stay for those patients admitted through the emergency department. To do this we compared two separate, two-week periods before and after the introduction of this new electronic signout format. Users were not informed of the study. Information recorded on the signout included details of the emergency admissions, consults received on call and any issues with regard to inpatients. ASA grade, time to first intervention and admission diagnosis were also recorded. Our results show that introduction of this electronic signout significantly reduced median length of stay from five to four days (P = 0.047). No significant difference in ASA grades, time to first intervention or overall admission diagnosis was obtained between the two time periods. In conclusion, this is the first study to show that the introduction of electronic signout post-call was associated with a significant reduction in patient length of stay and provided better continuity of care than the previously used paper-based handover. (C) 2010 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.