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Biomedical subjects

Laura A Noirot

Publications and source records attributed to Laura A Noirot.

4 recordsLinked to original sources

Monitoring pharmacy expert system performance using statistical process control methodology.

Automated expert systems provide a reliable and effective way to improve patient safety in a hospital environment. Their ability to analyze large amounts of data without fatigue is a decided advantage over clinicians who perform the same tasks. As dependence on expert systems increase and the systems become more complex, it is important to closely monitor their performance. Failure to generate alerts can jeopardize the health and safety of patients, while generating excessive false positive alerts can lead to valid alerts being dismissed as noise. In this study, statistical process control charts were used to monitor an expert system, and the strengths and weaknesses of this technology are presented.

Clinical Pharmacy Information Systems↗

Validation of automated event triggers using laboratory values related to two problem-prone drugs.

We used computerized alerts to identify patients with laboratory values that could be related to medication errors associated with digoxin and warfarin. Over a six-week period at two inpatient facilities, we generated 62 laboratory-based alerts for warfarin, and 66 for digoxin. The positive predictive value for these alerts representing a preventable event was 71% and 57% for warfarin and digoxin, respectively.

Anticoagulants↗

Implementing a commercial rule base as a medication order safety net.

A commercial rule base was used to identify drug orders exceeding standard dosage limits at a university hospital. Initially, there were substantial numbers of clinically insignificant alerts. A method for altering the commercial rule base will be implemented to increase rule specificity for problematic drugs. With minor modifications, commercial rule bases can be used to rapidly create a safety net that screens drug orders for excessive dosages, while preserving the rule architecture for more finely tuned clinical decision support.

Drug Therapy, Computer-Assisted↗

Implementation of an automated guideline monitor for secondary prevention of acute myocardial infarction.

Clinical practice guidelines can be used to help improve health care quality, but they are often not optimally implemented. Practice enabling and reinforcing techniques, such as clinical reminders and academic detailing are effective methods for translating guidelines into practice. Following a study showing that we could improve adherence to secondary prevention guidelines for acute myocardial infarction (AMI) using computerized alerts and academic detailing, we implemented an automated monitor to accomplish the same goal in a less labor-intensive manner. This paper describes the implementation of this production application.

Drug Therapy, Computer-Assisted↗