An Automatic Notification System for Test Results Finalized after Discharge
出院后确定测试结果的自动通知系统
基本信息
- 批准号:7773972
- 负责人:
- 金额:$ 16.99万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2009
- 资助国家:美国
- 起止时间:2009-09-30 至 2011-09-29
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
DESCRIPTION (provided by applicant): Abstract: The transition to the ambulatory setting following hospital discharge is a vulnerable time for patients. One important patient safety concern is failure of responsible providers to reliably follow up test results finalized after a patient is discharged. Such failure can lead to delays in diagnosis, missed treatment opportunities, redundant ordering of tests, and subsequent patient harm. Automated systems that ensure timely notification of these test results to responsible providers have the potential to mitigate these well documented problems and improve health care quality and safety. The goals of this project are to create an information technology-based automatic notification system to prompt responsible physicians of test results finalized after discharge and to evaluate the impact of this system on physician awareness of these test results. In the first phase of this study, the components of the system will be designed. These include 1) a query of all tests whose final results are pending at the time of discharge, 2) a query for the identity and email
addresses of the patient's responsible inpatient and ambulatory provider, 3) logic to exclude routinely ordered inpatient tests to avoid provider alert fatigue, 4) automatic email notification of finalized test results to responsible providers once they are available, and 5) documentation of these results in the ambulatory electronic medical record. The system is designed to facilitate timely communication and the creation of a collaborative plan of care among inpatient and outpatient providers during a patient's transition to the ambulatory setting. A cluster randomized controlled trial will be conducted to measure the impact of such a system on physician awareness. To minimize contamination, both inpatient and ambulatory providers will be randomized, and patients will only be enrolled if both responsible physicians are in the same arm of the study. Study subjects will include patients discharged from the inpatient general medicine and cardiology services at Brigham and Women's Hospital. The primary outcome will be awareness of all post-discharge test results among responsible providers. Secondary outcomes will include user satisfaction, awareness of actionable test results (as judged by providers), and whether appropriate actions are subsequently taken in response to these results (based on electronic medical record review). Physician awareness will be determined using an email survey to providers 72 hours after the first finalized test result is available. The primary outcome will be analyzed as the proportion of test results per patient of which a provider is aware using binomial logistic
regression. General estimating equations will be used to adjust for patient and physician characteristics and to cluster by physician. Over a six-month study period, 450 patients will be enrolled in order to provide adequate power to detect an improvement in awareness from 40% to 60% of results. The results of this study will inform future efforts to optimize this type of intervention both at BWH and at other institutions trying to solve this important patient safety problem.
描述(由申请人提供):摘要:出院后向门诊环境的过渡对患者来说是一个脆弱的时期。 一个重要的患者安全问题是负责的提供者未能可靠地跟踪患者出院后最终确定的测试结果。这种失败可能导致诊断延迟,错过治疗机会,重复订购测试以及随后的患者伤害。确保及时将这些测试结果通知给负责的提供者的自动化系统有可能减轻这些有据可查的问题,并提高医疗质量和安全性。本项目的目标是创建一个基于信息技术的自动通知系统,以提示负责的医生出院后完成的测试结果,并评估该系统对医生了解这些测试结果的影响。在这项研究的第一阶段,将设计系统的组成部分。这些包括1)查询其最终结果在出院时待定的所有测试,2)查询身份和电子邮件
患者的负责的住院和门诊提供者的地址,3)排除常规安排的住院测试以避免提供者警报疲劳的逻辑,4)一旦最终测试结果可用,则自动将最终测试结果的电子邮件通知给负责的提供者,以及5)在门诊电子医疗记录中记录这些结果。该系统的目的是促进及时沟通,并在病人过渡到门诊设置的住院和门诊提供者之间的护理合作计划的创建。将进行一项群集随机对照试验,以衡量这种系统对医生意识的影响。为了尽量减少污染,将对住院和门诊提供者进行随机化,只有当两名负责医生都在研究的同一组时,患者才能入组。研究受试者将包括从布里格姆妇女医院的住院普通内科和心脏病学服务出院的患者。主要结果将是负责提供者了解所有出院后检查结果。次要结局将包括用户满意度、对可采取行动的检测结果的了解(由提供者判断)以及随后是否采取适当措施来响应这些结果(基于电子病历审查)。在第一个最终测试结果可用后72小时,将通过向提供者发送电子邮件调查来确定医生的意识。主要结局将分析为提供者知道的每例患者的检查结果比例,使用二项logistic
回归分析一般估计方程将用于调整患者和医生特征,并按医生进行聚类。在6个月的研究期间,将招募450名患者,以提供足够的把握度来检测40%至60%的结果的意识改善。这项研究的结果将为BWH和其他试图解决这一重要患者安全问题的机构优化这种干预措施的未来努力提供信息。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Anuj K Dalal其他文献
Anuj K Dalal的其他文献
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{{ truncateString('Anuj K Dalal', 18)}}的其他基金
Demonstrating the potential for electronic health record interoperability to improve patient safety research of older adults over the acute episode of care.
展示电子健康记录互操作性的潜力,以改善老年人急性护理期间的患者安全研究。
- 批准号:
10728699 - 财政年份:2023
- 资助金额:
$ 16.99万 - 项目类别:
Real-time symptom monitoring using ePROs to prevent adverse events during care transitions
使用 ePRO 进行实时症状监测,以预防护理过渡期间的不良事件
- 批准号:
10494143 - 财政年份:2021
- 资助金额:
$ 16.99万 - 项目类别:
Real-time symptom monitoring using ePROs to prevent adverse events during care transitions
使用 ePRO 进行实时症状监测,以预防护理过渡期间的不良事件
- 批准号:
10345512 - 财政年份:2021
- 资助金额:
$ 16.99万 - 项目类别:
An Automatic Notification System for Test Results Finalized after Discharge
出院后确定测试结果的自动通知系统
- 批准号:
7935467 - 财政年份:2009
- 资助金额:
$ 16.99万 - 项目类别:
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