超越医院级聚合数据:一种方法来调整来自电子健康记录的临床数据,用于护理单位级研究
Christine Yang1,2,3, Mark K Kuebeler1,2,3, Rebecca Jiang1,2,3
1Michael E. DeBakey VA Medical Center, Houston, TX.
Medical care
|January 5, 2024
概括
将电子健康记录数据与特定的护理单位联系起来,对于明智的人员决策至关重要. 这种方法可以进行单位级分析,改善医疗机构的患者护理和运营效率.
科学领域:
- 医疗信息学 医疗信息学
- 护理研究 护理研究
- 医疗保健管理的管理
背景情况:
- 现有的护士人事研究通常依赖于医院一级的汇总数据,缺乏有效的单位特定决策的细节性.
- 这种局限性阻碍了护士管理人员根据实时单位需求做出明智的前线人员调整的能力.
研究的目的:
- 开发和描述一种方法来将患者级电子健康记录 (EHR) 数据与提供护理的特定护理单位联系起来.
- 创建一个国家数据集,准确地反映单位层面的患者护理,促进特定背景的研究和操作分析.
主要方法:
- 退伍军人卫生管理局 (VHA) 从2019年开始使用的急症住院治疗.
- 通过穿越路线将患者级别的EHR和条形码药物管理 (BCMA) 数据与护理单位联系起来.
- 根据时间标记的位置和计算的单位级患者风险得分,将入院时间划分为病房停留时间.
主要成果:
- 在125个VHA设施中,成功将89.46%的病房住宿和93.10%的药物管理与特定的护理单位联系起来.
- 提取了1117个护理单位的数据,包括超过110万个病房住宿和1.47亿次药物管理.
- 与设施水平 (4.53) 相比,在单位水平 (4.71) 显示出更高的患者平均严重性得分.
结论:
- 准确识别护理单位对于利用电子健康记录数据来研究单位级护理现象至关重要.
- 这种方法为前线管理人员做出人员和资源分配决策提供了关键的特定背景信息,这对前线管理人员至关重要.
- 该方法提高了EHR数据的实用性,以改善护理研究和医疗保健运营管理.
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