Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Operating Room Information Systems”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMed1998

Motion sickness and development of synergy within the spatial orientation system. A hypothetical unifying concept.

Adaptation to research paradigms such as rotating rooms and optical alteration of visual feedback during movement results in development of perceptual-motor programs that provide the reflexive assistance that is necessary to skilled control of movement and balance. The discomfort and stomach awareness that occur during the adaptation process has been attributed to conflicting sensory information about the state of motion. Vestibular signals depend on the kinematics of head movements irrespective of the presence or absence of signals from other senses. We propose that sensory conflict when vestibular signals are at least one component of the conflict are innately disturbing and unpleasant. This innate reaction is part of a continuum that operates early in life to prevent development of inefficient perceptual-motor programs. This reaction operates irrespective of and in addition to reward and punishment from parental guidance or goal attainment to yield efficient control of whole body movement in the operating environment of the individual. The same mechanism is involved in adapting the spatial orientation system to strange environments. This conceptual model "explains" why motion sickness is associated with adaptation to novel environments and is in general consistent with motion sickness literature.

Adaptation, Physiological↗
PubMedDate not supplied

Continuous quality improvement efforts increase operating room efficiency.

The surgical service at the Philadelphia Department of Veterans Affairs Medical Center has been making a continuous effort toward improving efficiency in the operating room. A multidisciplinary task force was created in May 1994 to look at delays in operating room start times for the first case of the day. This article identifies problems that contributed to the delays and the changes implemented, along with a statistical analysis of the data collected. The team discovered that delays were related to system problems in the perioperative process and were not caused by any specific problem. Many of these problems proved correctable, as the statistical analysis shows, and the result was significant improvement in operating room efficiency.

Appointments and Schedules↗
PubMed1975

First experiences with a documentation system via display terminals.

A documentation and monitoring system has been developed by members of the Department of Anesthesiology and the Department of Medical Data Processing of the Rheinisch-Westfälische Technische Hochschule Aachen. It is conceived in such a way that it should cover all the needs of the department, which is to say that every anesthesia done by a staff member should be documented, supervised and assisted by the computer service. The anesthesiological staff works only with 16 color visual display units, which are installed in the different operation theatres and in the intensive care unit of the department. These devices are used as an inquiry-response system for the dialogue between medical operator and computer. They display both alphanumerics and graphics in four different colors and modes. Information is entered in the system via so-called masks, which contain a larger section of information, and by on-line data recording.

Anesthesiology↗
PubMed1993

An automated radiology reporting system that uses HyperCard.

SCRIBE is an automated radiology reporting system that uses the HyperCard environment on Macintosh computers. Radiologic findings and anatomic terms are presented in graphic form, and the appropriate terms are selected by using a trackball or touch-sensitive video screen. Additional lists of more specific terms and differential diagnoses can be requested by the user for abnormal findings. The system is suited to the reporting of plain films and is being used in the emergency room of a large academic radiology department. Advantages of the system include low cost, operational familiarity to Macintosh users, and elimination of transcription costs. Finished reports are immediately available in both printed and electronic forms.

Humans↗
PubMed1996

Automated system for detailed measurement of respiratory mechanics.

OBJECTIVE: The mechanical properties of the respiratory system (i.e., elastance and resistance) depend on the frequency, tidal volume, and shape of the flow waveform used for forcing. We developed a system to facilitate accurate measurements of elastance and resistance in laboratory and clinical settings at the frequencies and tidal volumes in the physiologic range of breathing. METHODS: A personal computer (PC) is used to drive a common clinically used ventilator while simultaneously collecting measurements of airway flow, airway pressure, and esophageal pressure from the experimental subject or animal at different frequencies and tidal volumes. Analysis analogous to discrete Fourier transform at the fundamental frequency (i.e., ventilator setting) is used to calculate elastances and resistances of the total respiratory system and its components, the lungs and the chest wall. We have shown that this analysis is independent of the high-frequency harmonics that are present in the waveform from clinical ventilators. RESULTS: The system has been used successfully to make measurements in anesthetized/paralyzed dogs and awake or anesthetized human volunteers in the laboratory, and in anesthetized human volunteers in the laboratory, and in anesthetized humans in the operating room and intensive care unit. Elastances and resistances obtained with this approach are the same as those obtained during more controlled conditions, e.g., sinusoidal forcing. CONCLUSIONS: Accurate, standardized measurements of lung and chest wall properties can be obtained in many settings with relative ease with the system described. These properties, and their frequency and tidal volume dependences in the physiologic range, provide important information to aid in the understanding of changes in respiratory function caused by day-to-day conditions, clinical intervention and pathologies.

Airway Resistance↗
PubMedDate not supplied

In vivo optical coherence tomography of the nasal mucosa.

BACKGROUND: Optical coherence tomography (OCT) is an emerging imaging modality that uses light to produce in vivo high-resolution cross-sectional images (7 microm) of tissues to depths of up to 3 mm. OCT is analogous to ultrasound, but relies on interferometry and low-coherence optical sources to produce images of tissue structure at the histological level. METHODS: In this study, OCT was used to image the mucosa overlying structures in the nasal cavity to obtain information regarding normative in vivo tissue microstructure. An OCT system using a Michaelson interferometer and a 1.3-microm broadband light source was incorporated into a fiber-optic imaging device that was inserted into the nasal cavity. Cross-sectional tomographic images of the anterior and posterior nasal septum, turbinates, and vestibule were acquired in 44 patients in either the office or the operating room during surgical endoscopy. RESULTS: OCT images of the nasal mucosa identified the distinct boundaries between the epithelium, lamina propria, and underlying bone/cartilaginous tissue. Within the lamina propria, features consistent with glands, ducts, and blood vessels were clearly identified. In patients who underwent decongestant therapy, before and after images showed distinct morphological changes in the mucosa. The thickness of the epithelium was tabulated, as well. CONCLUSION: This study establishes the potential of using OCT to produce high-resolution images of the nasal mucosa. As an in vivo tissue microstructural imaging modality, OCT may be valuable in studying the impact of allergic and infectious disease on the nasal mucosa and monitoring its response to pharmacologic therapy.

Adolescent↗
PubMed1976

[Documentation of obstetric case reports by means of video-terminals as a part of the Vienna General medical information system "WAMIS" (author's transl)].

A report is given on the introduction of a complete documentation system of obstetric case reports by means of video-terminals and printer-terminals in both departments of Obstetrics and Gynaecology of the 1niversity of Vienna. The special routine for the admission of patients, which produces the heading of the case report is demonstrated, as well as the sheets of collecting the data in respect to case history, antenatal examinations, labour room reports and details of obstetric operations. The computer prints the case history using the collected data. These computer-printed case reports replace the customary handwritten reports. Laboratory data, therapeutic measures and final diagnosis are computed in the same way. The advantages of this form of organization of data collection for clinical purposes and research work are discussed.

Austria↗
PubMed2001

Anesthesia alarms in context: an observational study.

This paper surveys current work on the design of alarms for anesthesia environments and notes some of the problems arising from the need to interpret alarms in context. Anesthetists' responses to audible alarms in the operating room were observed across four types of surgical procedure (laparoscopic, arthroscopic, cardiac, and intracranial) and across three phases of a procedure (induction, maintenance, and emergence). Alarms were classified as (a) requiring a corrective response, (b) being the intended result of a decision, (c) being ignored as a nuisance alarm, or (d) functioning as a reminder. Results revealed strong effects of the type of procedure and phase of procedure on the number and rate of audible alarms. Some alarms were relatively confined to specific phases; others were seen across phases, and responses differed according to phase. These results were interpreted in light of their significance for the development of effective alarm systems. Actual or potential applications of this research include the design of alarm systems that are more informative and more sensitive to operative context than are current systems.

Anesthesia, General↗
PubMed1982

A micro-computerized anaesthetic record system.

An anesthetic record system has been implemented using a micro-computer, rather than a larger computer system. The record system provides a wide range of functions, including record retrieval, random record processing, and the generation of graphical reports on the department's operating room performance. The steps taken in realizing this system are described, with emphasis on the preparatory decisions that must be made before computer programming can be undertaken. Adopting a modest straightforward design philosophy is shown to be an important pre-requisite to success.

Anesthesiology↗
PubMed2004

Communication failures in the operating room: an observational classification of recurrent types and effects.

BACKGROUND: Ineffective team communication is frequently at the root of medical error. The objective of this study was to describe the characteristics of communication failures in the operating room (OR) and to classify their effects. This study was part of a larger project to develop a team checklist to improve communication in the OR. METHODS: Trained observers recorded 90 hours of observation during 48 surgical procedures. Ninety four team members participated from anesthesia (16 staff, 6 fellows, 3 residents), surgery (14 staff, 8 fellows, 13 residents, 3 clerks), and nursing (31 staff). Field notes recording procedurally relevant communication events were analysed using a framework which considered the content, audience, purpose, and occasion of a communication exchange. A communication failure was defined as an event that was flawed in one or more of these dimensions. RESULTS: 421 communication events were noted, of which 129 were categorized as communication failures. Failure types included "occasion" (45.7% of instances) where timing was poor; "content" (35.7%) where information was missing or inaccurate, "purpose" (24.0%) where issues were not resolved, and "audience" (20.9%) where key individuals were excluded. 36.4% of failures resulted in visible effects on system processes including inefficiency, team tension, resource waste, workaround, delay, patient inconvenience and procedural error. CONCLUSION: Communication failures in the OR exhibited a common set of problems. They occurred in approximately 30% of team exchanges and a third of these resulted in effects which jeopardized patient safety by increasing cognitive load, interrupting routine, and increasing tension in the OR.

Anesthesia Department, Hospital↗
PubMed1997

Surgical smoke evacuation systems.

Surgical smoke evacuation systems are high-flow vacuum sources used to capture, at the surgical site, the smoke aerosols and gases generated during the use of lasers and electrosurgical units (ESUs). In this study, we evaluated 16 evacuation systems, from 10 suppliers, designed and marketed for use in the operating room for general surgery. For our testing, we focused on the performance of the systems (particularly their ability to capture smoke particles under simulated surgical conditions) and their ease of use and quality of construction. We also examined the projected costs of each system over a seven-year life cycle. We rated the systems separately for two different evacuation applications (1) general-purpose applications, for which the system would, in many cases, be used with a handheld nozzle (the traditional capture device used with these systems), and (2) ESU-pencil-based evacuation applications only, for which the system would always be used with a pencil-based wand. (We report on ESU-pencil-based smoke evacuation wands in a separate Evaluation in this issue.) While we found most units to be Acceptable, we did rate two units Acceptable-Not Recommended for both applications and one unit Unacceptable for general-purpose applications. In addition to our findings for the evaluated models, this study features several sections providing generic information and guidance about smoke evacuation technology. The Technology Overview describes the basics: what these systems do and how they do it. The Technology Management Guide, "Clearing the Air-Should Surgical Smoke Be Evacuated?," discusses the issues healthcare facilities should consider when determining whether, when, and how surgical smoke should be evacuated. Finally, the Selection, Purchasing, and Use Guide offers guidance on how facilities can most effectively implement this technology, from identifying models that will meet their needs to ensuring that the systems are used properly to provide adequate staff protection.

Carcinogens↗
PubMed1996

Impact of working environments upon human-machine dialogues: a formal logic for the integrated specification of physical and cognitive ergonomic constraints on user interface design.

A range of techniques have been developed to improve the integration of computer systems into complex working environments. For instance, computer aided design tools can be used to simulate operators' posture at a particular workstation. Fitting studies can then be used to validate potential layouts. Unfortunately, few of these techniques can also be used to support the development of interactive dialogues. This is a critical problem for systems where designers must distribute application data amongst a number of different presentation devices. The position of these displays can be used to reflect the salience and priority of information. This paper presents techniques that support both user interface development and workstation layout. First order logic can be used to represent and reason about constraints on the design of human computer dialogues. The same formalism can also be used to identify appropriate locations for presentation devices within their working context; control rooms and offices. The findings of ergonomic studies can then be applied to analyze the mental and physical demands imposed by the interactive dialogues that are supported by particular devices. Unfortunately, formal specifications provide little impression of what it would be like to interact with a system within a particular environment. We have developed simulation tools to address this problem. Prototype displays can be presented within three dimensional models of their working context. The resulting simulations are directly derived from formal specifications and can be shown to members of concurrent design teams. They also provide a medium for communication with potential operators.

Computer Systems↗
PubMed1997

Assessment of vertebral body motion during spine surgery.

STUDY DESIGN: In vitro and in vivo assessment of the accuracy of devices proposed for tracking spine motion during surgery; in vivo assessment of vertebral motion during spine surgery. OBJECTIVES: 1) To quantify the accuracy of newly designed vertebral body trackers; 2) to demonstrate the feasibility of tracking vertebral motion in a cadaveric model; and 3) to quantify the vertebral motion that occurs during spinal surgery. SUMMARY OF BACKGROUND DATA: Computer techniques are beginning to be applied to spine surgery. Validation of accuracy of methods of spinal tracking has not been reported. No information exists on the amount of vertebral motion that occurs during surgery. Because the new techniques require accurate positional information for the vertebral body, it is important to understand and evaluate methods of tracking vertebrae. METHODS: An optical tracking system (Northern Digital, Waterloo, Ontario, Canada) was used to track custom-designed trackers. The reliability and accuracy of the trackers were evaluated in vitro. The proposed tracking methodology for human testing was performed using a cadaveric model, and after successful completion, human testing was done in the operating room to evaluate the motion of two vertebral bodies during exposure for instrumentation of the lumbar spine. This technique was used to evaluate the custom designed trackers effectiveness for tracking vertebral bodies for pedicle screw insertion. RESULTS: The trackers developed were accurate and capable of tracking the motion of the spine. Measured motion of L3 and L4 during breathing was 1.3 mm, peak to peak. Maximal intraoperative motion of the vertebral bodies was 12.3 mm during maneuvers simulating dissection of soft tissue and targeting of spinal pedicles. CONCLUSIONS: Significant motion occurs in lumbar vertebral bodies during surgery. Breathing motion alone is up to 1.3 mm, and surgeon-induced motion up to 10 times greater. Vertebral body trackers for use with an optical position sensor were capable of measuring this motion.

Adult↗
PubMed2002

[Image fusion, virtual reality, robotics and navigation. Effects on surgical practice].

In the new minimally invasive surgical era, virtual reality, robotics, and image merging have become topics on their own, offering the potential to revolutionize current surgical treatment and assessment. Improved patient care in the digital age seems to be the primary impetus for continued efforts in the field of telesurgery. The progress in endoscopic surgery with regard to telesurgery is manifested by digitization of the pre-, intra-, and postoperative interaction with the patients' surgical disease via computer system integration: so-called Computer Assisted Surgery (CAS). The preoperative assessment can be improved by 3D organ reconstruction, as in virtual colonoscopy or cholangiography, and by planning and practicing surgery using virtual or simulated organs. When integrating all of the data recorded during this preoperative stage, an enhanced reality can be made possible to improve intra-operative patient interactions. CAS allows for increased three-dimensional accuracy, improved precision and the reproducibility of procedures. The ability to store the actions of the surgeon as digitized information also allows for universal, rapid distribution: i.e., the surgeon's activity can be transmitted to the other side of the operating room or to a remote site via high-speed communications links, as was recently demonstrated by our own team during the Lindbergh operation. Furthermore, the surgeon will be able to share his expertise and skill through teleconsultation and telemanipulation, bringing the patient closer to the expert surgical team through electronic means and opening the way to advanced and continuous surgical learning. Finally, for postoperative interaction, virtual reality and simulation can provide us with 4 dimensional images, time being the fourth dimension. This should allow physicians to have a better idea of the disease process in evolution, and treatment modifications based on this view can be anticipated. We are presently determining the accuracy and efficacy of 4 dimensional imaging compared to conventional evaluations.

Computer Systems↗
PubMed1990

[A microcomputer system for obstetrical ultrasonic examinations].

The author proposes microcomputer system for obstetric ultrasound examination "AKUZI", designed for work with personal computer "Pravec 286", "Pravec 16" and the similar IBM Pc/HT, PC/AT with operative memory 640 K, hard disk 20 MB, a floppy disk device, color or monochrome monitor and a matrix printing device M88, LQ 1050, CPF-135, ect. The system is destined for ultrasound consulting rooms, in which obstetric ultrasound examination is performed. Its basic functions are: ultrasound examination; outcome of pregnancy; a report for the work of the consulting room and a manual for prenatal disturbances, established by ultrasound. AKUZI includes information for 10,000 patients with 40,000 examinations. There is a possibility for statistical processing of the collected data.

Bulgaria↗
PubMed2003

Motor vehicle crash-related mortality is associated with prehospital and hospital-based resource availability.

BACKGROUND: To date, attempts to assess the relationship between motor vehicle collision (MVC)-related mortality and medical resources availability have largely been unsuccessful. METHODS: Information regarding sociodemographic characteristics, prehospital resources, and hospital-based resources for each county (n = 67) in the state of Alabama was obtained. MVC-related mortality rates (deaths per 1,000 collisions) by county were calculated and compared according to prehospital and hospital-based resource availability within each county after correcting for sociodemographic factors. RESULTS: Counties with 24-hour availability of a general surgeon, orthopedic surgeon, neurosurgeon, computed tomographic scanner, and operating room were shown to have decreased MVC-related mortality (relative risk [RR], 0.88). The same was true for those counties with hospitals classified as Level I-II (RR, 0.71) and Level III-IV (RR, 0.83) trauma centers compared with counties with no trauma centers. CONCLUSION: Appropriate, readily available hospital-based resources are associated with lower MVC-related mortality rates. This information may be useful in trauma system planning and development.

Accidents, Traffic↗
PubMed1996

New paradigms for new problems: expanding information technology in healthcare.

As healthcare moves from individual fee-for-services and single hospital systems to capitated contracts and integrated delivery systems (IDS), and then into Community Health Information Networks (CHINs), implementing a data warehouse is a realistic way to collect and transform data into meaningful information. However, healthcare differs from other industries because of its complexity. The software is more specialized, and many vendors have adopted proprietary operating systems that hold critical data hostage. Even when available, data is not integrated and is more convoluted than in other industries. To have a complete patient profile, there can be 750 critical data elements in a healthcare transaction, as compared to an estimated 150 data elements in a financial transaction. Historical, behavioral, and diagnostic information is needed at multiple points along the continuum of care: physician's office, rehabilitation, pharmacy, emergency room, laboratory, and hospital. Additionally, these points along the continuum must communicate with the community they serve and the purchasers of healthcare. This article looks at data warehousing and the different technologies available for consolidating and integrating information in the healthcare environment.

Community Networks↗
PubMed1993

[CT guided transsphenoidal surgery: report of nine cases].

We have developed a Computed Tomography system for use in the operating room and applied this CT system to intraoperative monitoring during transsphenoidal surgery. This system includes Toshiba TCT-300 CT system, mobile CT scanner gantry, digitally controlled operating table and head fixation system. Between June 1989 and Dec. 1989, CT guided transsphenoidal surgery was carried out in 9 cases in our department. The suprasellar masses were visualized directly during transphenoidal surgery and were removed safely and efficiently. Under this CT monitoring system the surgeon can obtain accurate information about the location and volume of residual tumor as well as about the important surrounding deeper structure. Another advantage of this system is that the digitally controlled operating table makes it possible to keep the patient in a head-up position, which lessens oozing from the parasellar region during transsphenoidal surgery. We believe the best application of this method is that for pituitary tumor with moderate suprasellar extension. Nine cases were reported in this paper which were operated on using this system. To our knowledge, this is the first report of use of intraoperative CT monitoring during transsphenoidal surgery.

Adenoma↗