RESUMO
We present an observational tool to capture computer usage patterns during rounds to inform designs of information and communication technology to support clinical discourse during rounds. The tool captures choreography and logistics of information exchanges supported by clinical information systems during rounds. We developed the tool as part of an ongoing video-recording study of communication to under-stand how, when, and why computers are used during multidisciplinary clinical rounds.
Assuntos
Instrução por Computador/métodos , Disseminação de Informação/métodos , Internato e Residência/métodos , Internato e Residência/organização & administração , Anamnese/métodos , Software , Interface Usuário-Computador , MarylandRESUMO
Trauma Triage errors are frequent and costly. What happens in pre-hospital care remains anecdotal because of the dual responsibility of treatment (resuscitation and stabilization) and documentation in a time-critical environment. Continuous pre-hospital vital signs waveforms and numerical trends were automatically collected in our study. Abnormalities of pulse oximeter oxygen saturation (< 95%) and validated heart rate (> 100/min) showed better prediction of injury severity, need for immediate blood transfusion, intra-abdominal surgery, tracheal intubation and chest tube insertion than Trauma Registry data or Pre-hospital provider estimations. Automated means of data collection introduced the potential for more accurate and objective reporting of patient vital signs helping in evaluating quality of care and establishing performance indicators and benchmarks. Addition of novel and existing non-invasive monitors and waveform analyses could make the pulse oximeter the decision aid of choice to improve trauma patient triage.
Assuntos
Sistemas de Apoio a Decisões Clínicas/organização & administração , Diagnóstico por Computador/métodos , Serviços Médicos de Emergência/métodos , Monitorização Fisiológica/métodos , Avaliação de Resultados em Cuidados de Saúde/métodos , Garantia da Qualidade dos Cuidados de Saúde/métodos , Triagem/métodos , Sinais Vitais , Humanos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
We developed a conceptual design of a mobile computing platform to support multi-disciplinary rounds in intensive care units.