Decision Support for Safer Surgery (DS3)

更安全手术的决策支持 (DS3)

• 批准号: 8037777
• 负责人: MAJED GEORGE TOMEH
• 金额: $ 29.16万
• 依托单位: QCMETRIX, INC.
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8037777
• 关键词: Address; Anesthesia procedures; Back; Caring; Cessation of life; Clinical; Clinical Decision Support Systems; Collection; Complex; Computer software; Computers; Data; Data Collection; Data Reporting; Decision Support Systems; Deep Vein Thrombosis; Development; Evaluation; Future; Goals; Guidelines; Health; Health Information System; Heart Arrest; Hospitals; Human Resources; Infection; Life; Link; Measures; Methods; Modeling; Myocardial Infarction; Operative Surgical Procedures; Outcome; Patients; Performance; Perioperative; Perioperative complication; Phase; Pneumonia; Postoperative Period; Prevention; Process; Process Measure; Prophylactic treatment; Provider; Recommendation; Risk; Risk Estimate; Risk Management; Site; Site Visit; Small Business Innovation Research Grant; Specific qualifier value; Surgical complication; Surveys; System; Testing; Thromboembolism; Time; TimeLine; Training; Update; Use Effectiveness; Venous; adverse outcome; base; cost; design; evidence base; evidence based guidelines; experience; improved; meetings; mortality; point of care; programs; prototype; software systems; statistics; usability

DESCRIPTION (provided by applicant): QCMetrix, Inc. proposes to expand upon the strengths of the National Surgical Quality Improvement Program (NSQIP) to develop, implement, and evaluate a software system, Decision Support for Safer Surgery (DS3). DS3 will inform the care provider of patient-specific risks for surgery and of evidence-based processes of care that will minimize these risks in real- time, and will facilitate the collection of Surgical Care Improvement Project (SCIP) measures. The CMS Surgical Care Improvement Program's (SCIP) performance measures are complex and will need aggressive implementation strategies. The National Surgical Quality Improvement Program (NSQIP) collects surgical data from participating hospitals and reports risk-adjusted surgical outcomes back to the hospital. The rationale for this proposal is to initiate the first steps of taking the NSQIP from retrospective data collection and reporting to real-time data collection and clinical decision support. The goals of DS3 are to assist care providers in improving performance on the SCIP measures and reducing surgical complications. Project Objectives. 1) Develop risk models to assist in patient risk evaluations and review and affirm SCIP processes of care. 2) Implement and integrate a clinical decision support system into the workflow of the care providers. 3) Test DS3 in two hospitals. 4) Measure and address barriers to implementation of decision support in the preoperative setting. 5) Measure the effect of DS3 implementation on concordance with SCIP process measures for the two hospitals. Project Methods. This is a 3-year Fast-Track proposal. In phase 1, a 6-month planning study, we will update the risk models previously constructed for perioperative surgical site infections, myocardial infarction and cardiac arrest, deep vein thrombosis, postoperative pneumonia, and mortality. We will conduct site visits to gather requirements for the DS3 system and we will prepare a planning document for Phase 2. In Phase 2, a 30-month implementation project, we will implement a DS3 prototype, link the system to existing health information systems, and live test the prototype at two hospitals. We will train care providers in the use of the system and will collect usage statistics. We will conduct surveys to document user experience and user opinion and will examine concordance with the SCIP measures before and after the introduction of the system. Benefits. Reducing surgical complications is a national focus. We expect the proposed decision support system to be instrumental in the workflow of surgical care. Patients will benefit from this system because it is focused on the reduction of surgical complications. Care providers will benefit from the system because the evidence-based care process will be made more consistent and efficient. Hospitals will benefit economically because the system is intended to reduce the cost of surgical complications and will meet pay-for-performance criteria.

描述（由申请人提供）：QCMetrix，Inc.建议扩大国家手术质量改进计划（NSQIP）的优势，以开发，实施和评估软件系统，更安全手术的决策支持（DS 3）。DS 3将告知护理提供者手术的患者特定风险以及将真实的最小化这些风险的循证护理流程，并将促进收集手术护理改善项目（SCIP）措施。CMS外科护理改进计划（SCIP）的绩效指标很复杂，需要积极的实施策略。国家手术质量改进计划（NSQIP）从参与医院收集手术数据，并将风险调整后的手术结果报告给医院。该提案的基本原理是启动NSQIP从回顾性数据收集和报告到实时数据收集和临床决策支持的第一步。DS 3的目标是帮助护理提供者提高SCIP措施的性能并减少手术并发症。项目目标。1)开发风险模型，以协助患者风险评估，并审查和确认SCIP护理流程。2)实施并将临床决策支持系统整合到护理提供者的工作流程中。3)在两家医院测试DS 3。4)测量和解决术前决策支持实施的障碍。5)测量DS 3实施对两家医院与SCIP流程措施一致性的影响。项目方法。这是一个为期三年的快速通道提案。在为期6个月的第1阶段计划研究中，我们将更新之前构建的围手术期手术部位感染、心肌梗死和心脏骤停、深静脉血栓形成、术后肺炎和死亡率的风险模型。我们会进行实地考察，搜集DS 3系统的需求，并会拟备第二期的规划文件。在为期30个月的第二阶段实施项目中，我们将实施一个DS 3原型，将该系统与现有的卫生信息系统连接起来，并在两家医院对原型进行现场测试。我们将培训护理人员使用该系统，并收集使用统计数据。我们会进行调查，以记录使用者的体验和意见，并会在系统推出前后，研究系统是否与“持续改善信息计划”的措施一致。效益减少手术并发症是国家的重点。我们希望建议的决策支持系统是手术护理的工作流程中的工具。患者将受益于该系统，因为它专注于减少手术并发症。护理提供者将受益于该系统，因为循证护理过程将更加一致和有效。医院将在经济上受益，因为该系统旨在降低手术并发症的成本，并将满足按绩效付费的标准。

项目成果

Acceptability of the decision support for safer surgery tool.

对更安全手术工具的决策支持的可接受性。

• DOI: 10.1016/j.amjsurg.2014.06.037
• 发表时间: 2015
• 期刊: American journal of surgery
• 影响因子: 3
• 作者: Norton,WynneE;Hosokawa,PatrickW;Henderson,WilliamG;Volckmann,EricT;Pell,Joyce;Tomeh,MajedG;Glasgow,RobertE;Min,Sung-Joon;Neumayer,LeighA;Hawn,MaryT
• 通讯作者: Hawn,MaryT