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。尽管对患者的护理涵盖门诊和住院设置，但到目前为止，临床信息系统只关注门诊或住院患者，而不是两者都关注。我们的目标是展示综合门诊和住院健康信息系统的价值，以提高医疗质量和患者安全。孕妇在几个月内不可避免地要在住院和门诊之间转换，这是一个理想的情况，可以测试整合是否能产生影响。我们选择了一种常见且可能危及生命的疾病来证明我们的观点——B群链球菌。这项建议的具体目的是：

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.