Supporting Continuity of Care for Poisonings with Electronic Information Exchange

描述（由申请人提供）：中毒控制中心（PCC）和紧急部门（ED）之间的信息交换几乎完全通过电话进行。口头沟通是医疗错误的已知和常见来源，特别是在急诊科，其中提供者已知经历频繁中断的沉重通信负载。依赖口头沟通可能会造成数据丢失、治疗时间延迟和医疗错误。有可能减少医疗差错，减少治疗时间，并提高中毒护理的连续性与中毒控制中心和急诊室之间的电子信息交换。此外，电子信息交换可以改善和支持沟通，改善临床医生在护理点的数据和信息的可用性，并确保及时跟进。本研究将描述中毒控制和急诊部门之间的电子信息交换的信息要求，以支持个别患者的护理和护理过渡，描述当前的信息交换方案，并确定临床，操作和法律的考虑因素，重要的电子信息交换之间的ED和PCC。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，审查文件，分析记录的毒物控制中心电话，故事板和领域分析建模。我们将通过四轮德尔菲研究，确定各国专家对突出问题的共识。这项研究的结果将为PCC-ED信息交换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，标准的采用或开发以及政策。长期影响包括研究结果，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：本研究分析了中毒控制中心和急诊科在照顾中毒患者时共享信息的方式。它还将确定电子交换临床信息的国家障碍，因为电子交换可以通过减少医疗错误和加速中毒患者的治疗来更好地支持中毒患者的护理。

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.