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Objective To compare the change of management time for patients with acute cerebrovascular disease before and after re-accreditation of Grade Ⅲ Class A in a general hospital.Methods Electronic medical records of 490 patients diagnosed as acute cerebrovascular disease(215 cases of cerebral infarction,275 cases of cerebral hemorrhage) managed in Zhongnan Hospital of Wuhan University from June 2015 to July 2016 were collected,including 262 patients managed before re-accreditation (group A,June 2015 to December 2015) and 228 patients admitted after re-accreditation (group B,January 2016 to July 2016).In group A,there were 109 cases of cerebral infarction and 153 cases of cerebral hemorrhage(68 caused by trauma);in group B there were 106 cases of cerebral infarction and 122 cases of cerebral hemorrhage(54 caused by trauma).The time in emergency department (ED time),time waiting for admission (admission time) and the total management time (total time) were analyzed and compared between two groups.Results The ED time in group A and group B was 44.5 (30.0,71.5) and 39.0 (20.3,69.0) min (Z =-2.103,P =0.036) respectively;the admission time was 35.0 (25.8,50.0) and 39.0 (27.3,55.8) min(Z =-2.211,P=0.027);and total time was 85.0(62.8,120.0)and 82.5(61.0,119.0) min(Z =-0.356,P =0.722) in two groups respectively.For patients of cerebral infarction in group A and B the ED time was 49.0 (33.5,81.5) and 41.0 (29.8,74.3) min(Z =-1.872,P =0.061);the admission time was 37.0(27.0,52.0) and 36.0(25.0,52.3) min(Z =-0.516,P =0.606);and total timewas97.0(69.5,131.0)and 83.5(62.0,118.3) min(Z=-1.914,P=0.056).For patients of cerebral hemorrhage in group A and B,the ED time was 42.0 (28.0,64.0) and 35.0 (17.8,65.0) min (Z=-1.426,P =0.154);the admission time was 34.0(24.5,49.0)and 41.0(31.0,61.0) min (Z=-3.353,P =0.001);and total time was 79.0(58.0,108.0) and 82.0(60.0,120.8) min (Z =-1.052,P =0.293).Conclusions After re-accreditation of Grade Ⅲ Class A Hospital the total waiting time for patients of cerebral infarction is decreased significantly in emergency department,however,for patients of cerebral hemorrhage the waiting time for admission is longer.
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OBJETIVO: Auxiliar comissões de revisão de casos de óbito com um registro de óbito informatizado capaz de calcular automaticamente índices de trauma e gerar análises relevantes para avaliação dos casos e tomada de decisão. MÉTODOS: Desenvolvimento de aplicação web utilizando modelo de software como serviço para computação em nuvem com requisitos levantados por meio de revisão bibliográfica. RESULTADOS: Implementação de aplicação web com interface amigável ao usuário e de fácil utilização, com ferramentas para avaliação e análises dos dados de óbito em trauma. CONCLUSÃO: A aplicação possui diversas funcionalidades para apoio às avaliações das comissões de óbito. A análise do caso de forma global pela comissão de avaliação de óbito, identificando os problemas que eventualmente possam ter ocorrido e as medidas que poderiam ter sido feitas para que o resultado final não fosse o óbito do paciente. Desta forma, pode-se determinar quais as estratégias de correções que podem ser feitas.
OBJECTIVE: development of computerized record of the panel reviews of trauma mortality that can automatically calculate trauma indexes and generate relevant analyzes to assess clinical cases and decision making. METHODS: web application development using software as a service for cloud computing. RESULTS: Pilot project tested in Redcap contributed the implementation of web application user-friendly interface and easy to use, with tools for evaluation and analysis of death data in trauma cases. CONCLUSION: The application developed and pre-tested in Redcap has several features to support assessments of death committees. The analysis of the case globally by trauma mortality review panel, identifying the problems which might have occurred and the measures that could have prevented the death of the patient. Thus, one can determine which strategies corrections that can be made.