Rural hospital information technology implementation for safety and quality improvement: lessons learned.

This grant involved a hospital collaborative for excellence using information technology over 3-year period. The project activities focused on the improvement of patient care safety and quality in Southern rural and small community hospitals through the use of technology and education. The technology component of the design involved the implementation of a Web-based business analytic tool that allows hospitals to view data, create reports, and analyze their safety and quality data. Through a preimplementation and postimplementation comparative design, the focus of the implementation team was twofold: to recruit participant hospitals and to implement the technology at each of the 66 hospital sites. Rural hospitals were defined as acute care hospitals located in a county with a population of less than 100 000 or a state-administered Critical Access Hospital, making the total study population target 188 hospitals. Lessons learned during the information technology implementation of these hospitals are reflective of the unique culture, financial characteristics, organizational structure, and technology architecture of rural hospitals. Specific steps such as recruitment, information technology assessment, conference calls for project planning, data file extraction and transfer, technology training, use of e-mail, use of telephones, personnel management, and engaging information technology vendors were found to vary greatly among hospitals.

Ocorrência de Dengue no Estado de Säo Paulo, Brasil, de 1986 a 1996 / Occurence of dengue in Säo Paulo State, Brazil from 1986 to 1996

Desde 1986 casos de dengue vêm sendo detectados no Estado de Säo Paulo. De abril de 1986 a agosto de 1996, foram testadas 61.816 amostras de casos suspeitos, dos quais 21.891 foram confirmados, sendo 20.70 autóctones. A confirmaçäo foi feita por sorologia específica e/ou isolamento de vírus, critérios adotados pela Secretaria de Saúde do Estado de Säo Paulo. A incidência de dengue no período de 1987 a 1996 variou de 0,14 a 20,20 por 100.000 habitantes. As maiores incidências ocorreram nos veröes de 1990/1991, 1995 e 1996. Nestes anos a transmissäo ocorreu em 59, 101 e 114 municípios do Estado, o que representa 18,0(por cento), 24,3(por cento) e 27,3(por cento) dos municípios com infestaçäo domiciliar por Aedes aegypti. O sorotipo 1 foi o único identificado em casos autóctones até 1996, quando ocorreram dois isolamentos de Dengue tipo 2. Os dados apresentados analisam as atividades do sistema de vigilância epidemiológica relacionadas com a detecçäo de casos e diagnóstico laboratorial