Supporting Continuity of Care for Poisonings with Electronic Information Exchange

描述(由申请人提供)：毒物控制中心(PCCs)和急诊科(EDs)之间的信息交换几乎完全通过电话进行。言语交流是医疗差错的一个常见来源，尤其是在急诊科，众所周知，提供者经历了沉重的沟通负担和频繁的中断。依赖语言交流会造成大量数据丢失、延误治疗时间和医疗差错。通过毒物控制中心和急诊科之间的电子信息交换，有可能减少医疗差错，缩短治疗时间，并改善中毒护理的连续性。此外，电子信息交换可以改善和支持沟通，改善数据和信息在护理点提供给临床医生，并确保及时的随访。这项研究将描述毒物控制部门和急诊科之间为支持个别患者护理和护理过渡而进行电子信息交换的信息要求，描述当前的信息交换方案，并确定急诊室和急诊科之间电子信息交换的临床、操作和法律考虑因素。我们将使用多种方法，包括与临床医生和利益相关者的访谈、文档审查、对毒物控制中心通话录音的分析、故事板和领域分析建模。我们将通过四轮德尔菲研究确定国家专家对突出问题的共识。这项研究的结果将为与PCC-ED信息交流相关的有效研究和开发提供具体指导，包括信息技术解决方案、标准采用或制定以及政策。长期影响包括对结果的研究、质量改进创新以及计算机决策支持的潜力。 公共卫生相关性：这项研究分析了毒物控制中心和急诊科在护理中毒患者方面共享信息的方式。它还将确定临床信息电子交换的国家障碍，因为电子交换可以通过减少医疗差错和加快中毒患者的治疗来更好地支持对中毒患者的护理。

DESCRIPTION (provided by applicant): Exchange of information between poison control centers (PCCs) and emergency departments (EDs) is almost entirely conducted via telephone. Verbal communication is a known and frequent source of medical error, especially in emergency departments, where providers are known to experience heavy communication loads with frequent interruption. Reliance on verbal communication creates substantial potential for data loss, delayed time to treatment, and medical error. There exists a potential to reduce medical error, reduce time to treatment, and improve continuity of care for poisonings with electronic information exchange between poison control centers and emergency departments. Additionally, electronic information exchange could improve and support communication, improve the availability of data and information to clinicians at the point of care, and ensure timely follow up. This study will describe the information requirements for electronic information exchange between poison control and emergency departments in support of individual patient care and care transitions, describe current information exchange scenarios, and identify the clinical, operational, and legal considerations important for electronic information exchange between EDs and PCCs. We will use multiple approaches, including interviews with clinicians and stakeholders, review of documents, analysis of recorded poison control center calls, storyboarding, and domain analysis modeling. We will determine consensus among national experts on salient issues with a four round Delphi study. The results of this study will provide concrete guidance for efficient research and development related to PCC-ED information exchange, including information technology solutions, standards adoption or development, and policy. Long-term implications include the study of outcomes, quality improvement innovations, and the potential for computerized decision support. PUBLIC HEALTH RELEVANCE: This study analyzes the way in which poison control centers and emergency departments share information in caring for patients who have been poisoned. It will also identify national barriers to electronic exchange of clinical information, since electronic exchange could better support care of poisoned patients by reducing medical error, and speeding treatment of poisoned patients.