Development, Implementation, and Evaluation of the Surgical Bed Management System

手术床管理系统的开发、实施和评估

• 批准号: 7668737
• 负责人: KATHERINE S ROWELL
• 金额: $ 32.6万
• 依托单位: QCMETRIX, INC.
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-06-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7668737
• 关键词: Accounting; Administrator; Admission activity; Bed Occupancy; Beds; Blood Vessels; Caring; Comorbidity; Computer software; Data; Data Analyses; Development; Electronics; Evaluation; Exercise; Feedback; Health Information System; Hospital Administrators; Hospital Costs; Hospital Information Systems; Hospitalization; Hospitals; Human Resources; Income; Inpatients; Interview; Intranet; Lead; Leadership; Length of Stay; Link; Measures; Methods; Michigan; Online Systems; Operative Surgical Procedures; Outcome; Patients; Perioperative complication; Phase; Physicians; Process; Provider; Research Design; Resources; Risk; Secure; Severity of illness; Small Business Innovation Research Grant; Source; Statistical Models; Strategic Planning; Structure; Surveys; System; Testing; Time; TimeLine; Training; Universities; Variant; base; bed capacity; cohort; commercialization; design; improved; innovation; meetings; models and simulation; peer; primary outcome; programs; prototype; satisfaction; secondary outcome; simulation; software systems; technological innovation; tool; usability

DESCRIPTION (provided by applicant): Long-Term Objective: The duration of hospitalization, commonly known as length of stay (LOS), is a major determinant of hospital costs. The marked variation in LOS between hospitals for groups of patients with similar illnesses suggests there is room for improved efficiency. Our long-term objective is to create a software application linked to the hospital information system to enable hospitals to enhance their efficiency. The major innovation in this proposal is the use of severity of illness, type of surgical procedure, and perioperative complications to predict LOS, which can then be used for shorter-term bed management, longer-term projection of bed capacity and personnel, and compare LOS across providers. Specific Aims: The specific aims of this proposal are to construct, test, and evaluate a software module, the Surgical Bed Management System (SBMS), which will: 1) Use predicted LOS to manage admissions and discharges within a hospital; 2) Use predicted and actual LOS of a historical cohort of admissions (e.g., previous fiscal year) in a simulation model for strategic planning of bed capacity needs (e.g., the next fiscal year); and 3) Adjust LOS for severity of illness, comorbidity, and surgical procedure so that this measure of efficiency may be credibly compared across physicians and hospitals. Research Design and Methods: The SBMS will be a web-based software module linked to the hospital information system that facilitates gathering the necessary patient- and hospital-level data from the hospital's health information system and by direct data entry. The SBMS will estimate each patient's predicted LOS on admission and again shortly following surgery, and will aggregate and present this information as an electronic Predicted Bed-Occupancy Board for use in planning near-term admissions. Additionally, the SBMS will use hospital-specific- historical data in a simulation exercise to forecast long-term bed needs, and will compute risk- adjusted LOS for use in comparing efficiency with other hospitals. This is a two and one-half-year proposal, in which we propose to design and program prototypes, and secure user feedback in first year. We will implement SBMS and train users at the University of Michigan Hospital and conduct alpha testing during months 7 - 15, followed by use for all inpatient general and vascular surgery during months 16 - 30. We will then follow the same steps in a second hospital, Newton-Wellesley. During months 25 - 30, we will collect and analyze data from both hospitals to assess our outcomes. The primary outcome will be the change in risk-adjusted LOS during the last six months of implementation in the two test hospitals compared with the six months immediately preceding implementation. Secondary outcomes will be user satisfaction assessed with a survey instrument and an assessment of marketability based on structured interviews with key hospital leadership personnel.

描述（由申请人提供）：长期目标：住院时间，通常称为住院时间（LOS），是住院费用的主要决定因素。对于患有类似疾病的患者群体，医院之间的LOS存在显着差异，这表明效率还有提高的空间。我们的长远目标是开发一套与医院信息系统相连的应用软件，使医院能够提高效率。该提案的主要创新是使用疾病的严重程度，手术类型和围手术期并发症来预测LOS，然后可以用于短期床位管理，长期预测床位容量和人员，并比较不同提供者的LOS。 具体目标：本提案的具体目标是构建、测试和评估一个软件模块，即手术床管理系统（SBMS），该系统将：1）使用预测的LOS来管理医院内的入院和出院; 2）使用历史入院队列的预测和实际LOS（例如，前一财政年度）在用于床位容量需求的战略规划的模拟模型中（例如，下一个财政年度）; 3）根据疾病的严重程度、合并症和外科手术调整LOS，以便在医生和医院之间对这种效率的测量进行合理的比较。 研究设计和方法：SBMS将是一个基于网络的软件模块，与医院信息系统相连，便于从医院的健康信息系统收集必要的病人和医院数据，并直接输入数据。SBMS将在入院时和手术后不久估计每位患者的预测LOS，并将汇总和呈现此信息作为电子预测床位占用板，用于计划近期入院。此外，SBMS将在模拟演习中使用医院特定的历史数据来预测长期床位需求，并将计算风险调整后的服务水平，用于与其他医院进行效率比较。 这是一个为期两年半的提案，其中我们建议设计和编程原型，并在第一年获得用户反馈。我们将在密歇根大学医院实施SBMS并培训用户，并在7 - 15个月期间进行α测试，然后在16 - 30个月期间用于所有住院普通和血管手术。然后，我们将在第二家医院牛顿-韦尔斯利遵循同样的步骤。在25 - 30个月期间，我们将收集和分析两家医院的数据，以评估我们的结果。 主要结果将是在两个测试医院实施的最后六个月与实施前六个月相比，风险调整后的LOS的变化。次要结局将是使用调查工具评估的用户满意度和基于与关键医院领导人员的结构化访谈的市场化评估。