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At least 145 records · Page 8Linked to original sources
PubMed1997

Expediting the turnaround of radiology reports in a teaching hospital setting.

OBJECTIVE: The purpose of this study was to determine whether total quality management (TQM) techniques that had proved successful in a pilot study in one departmental section of a teaching hospital could be generalized for use by the entire radiology department. MATERIALS AND METHODS: Each departmental section developed interventions to improve its report turnaround time. These interventions were tailored to practice style and habits of each section. Commonly used interventions included electronic signature from the radiologist's home, a report-signing buddy system, elimination of a trainee signature requirement, accelerated transcription, structured reports, faster film delivery to reading desks, and training about the importance of radiology reports for clinical decision making. Specialized programs included computerized form-driven reporting and reports generated directly by computer voice recognition of radiologists' dictation. Our radiology information system provided data on each step in the reporting process. RESULTS: The TQM approach produced significant improvements in departmental total report turnaround time (-55%; p = .001), transcription time (-80%; p = .003), and signature time (-68%; p = .0004). Each section achieved significant gains. The sonography section initiated a computerized, form-driven reporting system and outperformed the rest of the department. CONCLUSIONS: TQM techniques can be expanded and generalized for department-wide projects in teaching hospitals.

Communication↗
PubMed1977

Progress toward a second generation Laboratory Information System (LIS).

A Laboratory Information System (LIS) is a convenient organization of programs and hardware designed to meet the health care delivery needs of a department of pathology. A full service LIS is now a commercially viable product and after 2 years of experience, certain desirable design features are evident for a second generation system. Such variables as hardware configuration, physical plant, libraries, diagnostic algorithms, system usage and surveillance, and manpower and human engineering are now significant operational features and essential for LIS acceptance by a department of pathology as well as the practicing medical staff.

Data Display↗
PubMed2001

Merits of duplicate LAN cabling in hospitals.

Our hospital wired three LAN cables separately to improve the data distribution range. One LAN is between the various sections of the hospital (hospital LAN), another is within each section (section LAN), and the other is connected to the Internet (open LAN). The section LAN was connected to the hospital LAN to enable data exchange. Data from the section LAN for common use is collected through the hospital LAN and stored in the central server The duplicate cabling and separate LANs increased the independence of each LAN and the system within each section. The section systems can be changed at anytime without the necessity of reconstructing the whole hospital information system. The data transfer speed of each cable increased. Hospital information processing systems often use a distributed-processing centralized management system. Because of advances in technology, each section can now take responsibility for developing their own system, making the responsibility of the information processing section responsible for hospital information systems more limited than previously. Herein, we show the merits of separate cable installation.

Centralized Hospital Services↗
PubMed1992

Do you computer take this television ...?

Just as computerized information systems are revolutionizing the way hospitals distribute patient information around the healthcare system, interactive video technology now is revolutionizing the way television sets are used in patient rooms. The TV set is becoming a source of hospital and patient information, and helps provide patient education.

Academic Medical Centers↗
PubMed1985

Clinical computing in a teaching hospital.

This report describes a hospital-wide clinical computing system that permits physicians, nurses, medical students, and other health workers to retrieve data from the clinical laboratories; to look up reports from the departments of radiology and pathology; to look up demographic data and outpatient visits; to look up prescriptions filled in the outpatient pharmacy; to perform bibliographic retrieval of the MEDLINE data base; to read, write, retract, edit, and forward electronic mail; and to request delivery of a patient's chart. During a one-week study period, from 300 video display terminals located throughout the hospital, 818 patient care providers used a common registry of 539,000 patients to look up clinical and laboratory data 16,768 times; 477 other hospital workers used the patient registry 46,579 times. In a separate study of 586 health care providers, 470 (80 per cent) indicated that they used computer terminals "most of the time" to look up laboratory results; in contrast, 48 (8 per cent) preferred printed reports. Of 545 hospital workers, 440 (81 per cent) indicated that the computer terminals definitely or probably made their work more accurate, and 452 (83 per cent) indicated that terminals enabled them to work faster. The large amount of use by clinicians and their judgment that the computer has been so helpful to them suggests that a reliable, comprehensive, and easy-to-use computer system can contribute substantially to the quality of patient care.

Boston↗
PubMed2003

IVR and administrative operations in healthcare and hospitals.

IVR (Interactive Voice Response) systems are effectively used in healthcare and hospitals for drug and health library information, prescription refills, history records, medical transcripts, patient information services, automated pre-admissions, patient account records, appointment scheduling and reminder, lab results notification, food services, and many other applications. Among its benefits, IVR relieves administrative staff and physicians of routine customer interactions and helps healthcare organizations increase their efficiency, productivity, and profitability.

Appointments and Schedules↗
PubMedDate not supplied

Graduating to an integrated system: Yale University Medical School and Yale-New Haven Hospital coordinate security.

UNLABELLED: The authors, security directors at Yale University Medical School and Yale-New Haven Hospital respectively, discuss their decision to coordinate their efforts to procure compatible new security systems that would integrate such components as alarms, CCTV, and access control within and between the two campuses. The goal: improve safety and make alarm monitoring easier and more efficient by centralizing operations. THE RESULTS: an increase in security, a decline in security incidents, and a reduction in costs.

Academic Medical Centers↗
PubMed2005

Ability of hospitalized older adults to use their call bell: a pilot study in a tertiary care teaching hospital.

BACKGROUND AND AIMS: Cognitive impairment, visual loss and decreased mobility may make it difficult for older patients to use a hospital call bell when they need help. Inability to call for help may cause harm that could potentially be modified. Despite the importance of this issue, to date no study has determined the ability of older hospitalized adults to use their call bell. The aim of this study was to determine what percentage of hospitalized patients, aged 70 and older, are capable of using their call bell. METHODS: The study used a cross-sectional design. Patients were enrolled from two different clinical units in a tertiary care teaching hospital. Subjects participated in a structured interview to determine whether or not they could use the hospital call bell. RESULTS: Thirty-seven patients were interviewed. Of these, eleven patients were unable to use the call bell, seven because it was out of reach and four because they were unaware of how to use it. Only two of the four patients diagnosed with dementia were aware of their hospital call bell, compared with 31 of 33 patients without dementia (p = 0.050). CONCLUSIONS: The present system of hospital care is based on the assumption that patients are able to get help by activating their call bell. However, a large percentage of hospitalized patients are unable to use this device. Ensuring that call bells are positioned within reach of patients and providing increased supervision to patients with dementia may reduce the rate of adverse events in hospital.

Aged↗
PubMedDate not supplied

Evacuation of a rural community hospital: lessons learned from an unplanned event.

A credible bomb threat forced the complete evacuation of a rural community hospital. An Incident Command System was implemented, and all 46 patients were temporarily transported and maintained at 2 local sites. They were returned to the hospital approximately 24 hours later. Only one patient experienced a complication possibly associated with the evacuation. This article discusses pertinent strategies and considerations involved in the planning and execution of a rural hospital evacuation. It further highlights the role of the emergency department medical and nursing staff throughout the evacuation process.

Community-Institutional Relations↗
PubMed2001

Implementation of a dynamic platform-independent DICOM-server.

Hospital-wide image and patient data transfer within heterogeneous hard- and software infrastructures can be facilitated by using standardized communication protocols and data formats such as digital imaging and communications in medicine (DICOM). Each DICOM application entity (AE) usually provides a static and fixed set of services according to its functionality. However, certain security concepts, changing demands of medical users, or restricted hardware capabilities may be more easily addressed by applications that dynamically provide variable subsets of DICOM services. In a new approach, an object-oriented DICOM server framework was developed that served as a basis for assembling various DICOM applications. These applications may be set up dynamically to offer variable subsets of services at runtime, similar to "plug-ins". The framework was designed and implemented in Java in order to provide low-cost platform-independent solutions. As an example, a DICOM server was implemented and tested in a clinical application providing access to MR and CT images through a Java/DICOM viewer. Data retrieval was optimized by storing parts of the image acquisition and patient data into a relational database.

Computer Systems↗
PubMed1999

[Hospital organization of cardiopulmonary resuscitation].

That hospital cardiopulmonary resuscitation (CPR) should be supported by an organized plan rather than on the skills of individual health care personnel is a universally agreed-upon principle. Such a plan should guarantee that needed materials are available and in working order in all departments and that the team assigned to carry out CPR arrives promptly. Personnel other than the specialized team should also receive CPR training appropriate to their posts. The main features of a CPR plan are related to the five steps in the chain of survival: a) identification of a patient to be resuscitated, a matter that has important ethical ramifications; b) early recognition of cardiac arrest; c) early defibrillation; d) basic CPR, and e) advanced CPR. The CPR plan should incorporate the automatic recording of system, population, event and outcome variables. Task forces responsible for establishing and maintaining the plan and its quality control will periodically review the data with the aim of detecting errors, correcting them or introducing improvements. Various international societies and CPR committees have recently suggested a uniform way (the Utstein style) of recording and presenting data to allow comparisons either from hospital to hospital or over time within a single center.

Cardiopulmonary Resuscitation↗
PubMed1978

Dealing with specimen problems in a computerised clinical chemistry laboratory.

The use of a laboratory computer system to deal with specimen problems is described. Problems such as 'insufficient material' or 'haemolysis' are entered by reception staff or by bench workers so that resolution of the problem will not be overlooked; problems are then listed and dealt with by the duty biochemist. Specimens on printed worksheets are annotated 'urgent' where appropriate. Results obtained on-line, which are above top standard, automatically cause the specimen to reappear on the next worksheet marked 'dilution required'. Data relating to its use over a three-month period are presented together with some comments on the causation of specimen problems and their prevention.

Chemistry, Clinical↗
PubMed2006

[Interhospital transportation of the severe pediatric patient in Catalonia].

OBJECTIVE: To describe the organization of the interhospital transport of the pediatric patients in Catalonia. DESIGN: Description of the different phases of organization, of the organizational structure, both of the bases and of the coordinating center, and of the evolution of the model. SCOPE: System of medical emergencies and hospital net of Catalonia. PERIOD: between 1996 and 2003. PATIENTS: Patients moved by the pediatric teams. INTERVENTIONS: Analysis of the documentation used in the transports realized by the system of medical emergencies. VARIABLES OF INTEREST: Clinical information, hours and times of transport, as well as the way used for the transport. RESULTS. A total of 6,110 pediatric transports were realized by an annual average of 777. The 94% of the movements carried out for ambulances and 6% with helicopter. The number of transport was growing to lengths of the years of study. CONCLUSIONS: The model followed in the last years in Catalonia bases on the specialization of the pediatric interhospital transport. The pediatric teams contribute a value added to the own transport.

Air Ambulances↗
PubMed1991

Support systems, facilities and staffing of clinics in Mhala, Gazankulu--are they adequate?

A study comprising in-depth interviews of sisters in all 15 rural clinics in the Mhala district of Gazankulu showed them to experience major problems with support systems: radiophone communication was unreliable (and even absent in 3 clinics); transport was inadequate; the cold chain was not well maintained and essential drugs and equipment were absent (only 1 clinic had all the equipment to manage a neonatal resuscitation adequately). There were also serious deficiencies in facilities, lack of running water and electricity posing the most serious problems (resulting in deliveries and suturing of episiotomies by candlelight). Other pressing problems include inadequate waiting space and patient privacy. Staffing at the clinics fell well below what is required, yet the commitment of staff was often inspiring. The state of the clinics must be seen within the constraints of 'homeland' policy and the unequal distribution of the country's health care resources. Despite these limitations the clinic service can be improved. Recommendations are made for this, concentrating on improving support structures rather than on the more costly improvement of facilities.

Ambulatory Care Facilities↗
PubMed1988

The sounds of the hospital. Paging patterns in three teaching hospitals.

To examine the influence of hospital paging systems on residency training, nursing services, and patient care, we asked medical interns (first-year residents) in three teaching hospitals to keep logs of pages they received during a three-day period. Thirty-one logs from 26 interns were completed; a total of 1206 pages were recorded on 91 days (1095 hours). Interns were paged an average of once an hour; on 24 occasions, interns were paged five or more times an hour. The majority of pages (65 percent) occurred when interns were engaged in patient care. Only 34 percent of the pages were judged both to require a response within one hour and to result in a change in patient care. Twenty-four percent were clinically indicated and required a response within one hour but did not result in a change in patient care. Sixteen percent of pages resulted in a change in patient care or were clinically indicated but could have been postponed for more than an hour. An additional 26 percent of pages neither resulted in a change in clinical management nor were clinically indicated. Reducing the number of unnecessary pages and postponing nonurgent ones could result in as much as a 42 percent decrease in disruptions of patient care and more rest for interns.

California↗
PubMed1992

Interrupted care. The effects of paging on pediatric resident activities.

OBJECTIVE: To determine the content and urgency of pages and their effect on the activities of pediatric residents. DESIGN: Prospective survey. SETTING: University-affiliated teaching hospital. PARTICIPANTS: Seventeen pediatric residents on regular pediatric services. INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: On daily logs, interns recorded the activity interrupted by a page and rated the urgency and importance of the page. Almost half of all pages interrupted patient care activities, and 24% interrupted scheduled work rounds or teaching conferences. Interns reported that 34% of pages resulted in a change in patient treatment, but they rated 25% of all pages as unimportant. CONCLUSIONS: "Beepers" frequently interrupt pediatric residents involved in patient care activities and scheduled educational conferences. Studies of interventions aimed at decreasing unnecessary interruptions by pages are needed.

Burnout, Professional↗