Improving Safety and Quality with Integrated Technology

描述（由申请人提供）：临床信息系统的不连续性给日常临床实践带来了很大的问题。尽管对患者的护理跨越门诊和住院设置，但到目前为止，临床信息系统专注于门诊或住院，而不是两者兼而有之。我们的目的是证明一个综合门诊和住院病人的健康信息系统，以提高医疗质量和病人的安全的价值。孕妇不可避免地在几个月内从住院病人和门诊病人过渡到门诊病人，这是一个理想的情况，可以测试整合是否会产生影响。 我们选择了一种常见的、可能危及生命的疾病来证明我们的点群B链。这项建议的具体目标是： - 测试一个系统是否传输GBS结果与住院警报，提高遵守循证治疗指南的妇女谁是GBS阳性（护理质量）。 - 证明上述干预是否减少了GBS阴性女性的抗生素不当使用（患者安全性）。 - 证明电子警报系统在门诊增加GBS筛查的价值。 - 执行成本效益分析，以评估实施HIT的影响。 这些数据将增加我们对集成HIT系统的价值的了解，以在安全和质量方面产生可衡量的改进。这些发现虽然专门适用于OB，但可以应用于医学和外科的许多领域。这些发现将为住院和门诊HIT利益相关者提供做出重要决策所需的信息。

DESCRIPTION (PROVIDED BY APPLICANT): Discontinuities in clinical information systems pose a large problem for everyday clinical practice. Although care for patients spans outpatient and inpatient settings, clinical information systems, until now, focus on either outpatient or inpatient but not both. We aim to demonstrate the value of an integrated outpatient and inpatient health information system to improve quality of health care and patient safety. Pregnant women inevitably transition across inpatient and outpatient settings in a matter of months, making this an ideal situation to test whether integration can makes a difference. We have chosen a common and potentially life threatening condition to demonstrate our point - group B streptococcus. The specific aims of this proposal are to: - Test whether a system that transmits GBS results with inpatient alerts improves adherence to evidence-based treatment guidelines for women who are GBS positive (quality of care). - Demonstrate whether the above intervention reduces inappropriate antibiotic use in women who are GBS negative (patient safety). - Demonstrate the value of an electronic alert system to increase GBS screening in the outpatient setting. - Perform a cost-benefit analysis to assess the impact of implementing HIT. These data will increase our knowledge about the value of integrated HIT systems to produce measurable improvements in safety and quality. The findings, though applied specifically for OB, can be applied to many areas of medicine and surgery. The findings will provide inpatient and outpatient HIT stakeholders needed information to make important decisions.