为患有医疗复杂性的儿童实施基于EHR的紧急信息表
Todd W Lyons1, Kathleen Huth2, Stacey C Cook2
1Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Hospital pediatrics
|August 3, 2025
概括
电子健康记录 (EHR) 中的紧急信息表格 (EIF) 为患有医疗复杂性 (CMC) 的儿童提供了准确的临床数据. 虽然EIF提高了护理准确性,但它们并不能加快紧急部门 (ED) 的处置决策.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
背景情况:
- 患有医疗复杂性 (CMC) 的儿童需要专门的护理,及时获得准确的临床信息对于有效的急诊部 (ED) 管理至关重要.
- 现有的信息系统可能无法充分支持在ED访问期间CMC的复杂需求.
研究的目的:
- 设计和实施基于电子健康记录 (EHR) 的紧急信息表 (EIF) 以改善CMC的ED护理.
- 评估EIF对CMCED护理流程和结果的可行性,利用和影响.
主要方法:
- 一个改进模式框架被用来让利益相关者参与EHR中的EIF的开发和实施.
- 欧洲医疗基金包括全面的患者总结,医院前分组,复苏状态和护理计划.
- 实施了基于EHR的警报系统,以通知EIF可用性的提供者. 测量结果包括处置时间,EIF准确性,护理实用性和住院率.
主要成果:
- 为311个CMC创建了EIF,在两年内支持了838次ED访问.
- 98%的ED提供者认为EIF包含准确的信息,86%的人认为它们加速了护理.
- 一项由临床医生领导的倡议将EIF利用率从42%提高到64%. 没有观察到ED处置时间的显著变化,但住院率略有降低 (53.4%至50.5%).
结论:
- 该研究表明了基于EHR的EIF的可行性和利用性,以提供及时和准确的临床信息,以支持CMC的ED护理.
- 虽然EIF提高了信息可访问性和看待护理的便利性,但它们没有明显影响ED处置效率.
- 进一步的研究可能会探索优化EIF集成以影响ED工作流程和患者处置时间.
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