一个学习健康系统的方法来实施和评估一个学术急诊室单一的共享笔记工作流
Bethany M Kwan1,2, Patrick Hosokawa2, Daniel Resnick-Ault1
1Department of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA.
Learning health systems
|October 31, 2025
概括
实施科学框架使用共享的笔记工作流程将紧急部门 (ED) 的笔记完成率提高了50%. 这种方法提高了临床医生的满意度,并支持学习健康系统 (LHS).
科学领域:
- 实施科学 (IS) 和学习健康系统 (LHS)
- 医疗保健服务研究 医疗服务研究
- 学术紧急医疗学术医学
背景情况:
- 学术急救部门 (EDs) 在质量改进举措方面面临挑战.
- 实施科学 (IS) 框架提供了一种结构化的方法来评估流程变化.
- 在科罗拉多大学卫生 (UCH) 编辑部实施了一种新的共享笔记工作流.
研究的目的:
- 评估共享笔记工作流对学术ED的质量改进的影响.
- 评估临床医生对新工作流程的满意度,知识和信心.
- 为了确定共享笔记工作流对电子健康记录 (EHR) 笔记完成率的影响.
主要方法:
- 利用变革实施模型和理论领域框架进行评估.
- 通过调查和Epic EHR遭遇数据收集数据.
- 使用描述性和回归分析,比较了2021年之前 (2021) 和2022年,2023年实施后 (2022) 的笔记完成率.
主要成果:
- 在实施后报告的高临床医生满意度,知识和信心.
- 与2021年相比,2022年轮班期间完成笔记增加了50% (OR=2.34).
- 与实施前相比,2023年 (OR=1.96) 的备注完成率仍然显著增加.
结论:
- 通过IS增强的评估显示了高满意度和在学术ED中提高了成绩.
- 共享笔记的工作流积极影响效率,并可能减少临床医生的倦怠.
- 来自IS方法的数据驱动洞察力支持维持共享笔记工作流.
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