实施一个闭环临床决策支持系统,以实现可持续的手术前护理
José Luis Gracia Martínez1, Bernadette Pfang2,3, Miguel Ángel Morales Coca4
1Anesthesiology Department, General Villalba University Hospital, Madrid, Spain. Jose.gracia@quironsalud.es.
NPJ digital medicine
|January 3, 2025
概括
实施电子健康记录集成临床决策支持系统 (CDSS) 显著减少了西班牙医院不必要的手术前检测. 这一举措提高了患者的安全性,并降低了医疗保健成本,而不会影响手术结果.
科学领域:
- 医疗信息学 医疗信息学
- 改善外科手术的质量
- 医疗保健经济学 医疗保健经济学
背景情况:
- 不必要的手术前检测导致患者安全风险,手术延迟和医疗保健支出增加.
- 集成到电子健康记录 (EHR) 中的临床决策支持系统 (CDSS) 为优化测试协议提供了一个潜在的解决方案.
研究的目的:
- 评估完全与EHR集成的闭环CDSS对手术前检测率的影响.
- 评估系统对患者安全,手术延迟和医疗保健成本的影响.
主要方法:
- 在马德里的两个教学医院,在69个月的时间里 (2018年1月 - 2023年10月) 进行了中断时间序列分析.
- 该研究包括228,671次外科手术,比较了CDSS实施前期 (78,388次手术) 和实施后期 (150,283次手术) 的数据.
主要成果:
- 在手术前测试中观察到显著的减少:胸部X射线83% ,心电图54% ,血型测试50%和血液测试订单组29% .
- 实施导致总体成本节约为1,013,666.6欧元.
- 没有发现术后不良事件或当天手术取消的增加.
结论:
- 嵌入EHR的闭环CDSS有效地减少了可避免的手术前检测.
- 这种技术干预提高了护理质量,并优化了医疗保健支出,而不会对手术结果或患者安全产生负面影响.
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