Re: Clinical IT increases the time intensive care nurses spend documenting care.
Is anyone able to get the actual document. One member of my Nusing Informatics list asked if it was caused by more manditory data collection, hopefully resulting in more complete documentation. Alric
Re: Clinical IT increases the time intensive care nurses spend documenting care.
Alric wrote: Is anyone able to get the actual document. You may buy it from the editor (I do not know why the electronic versions are not free): http://www.blackwell-synergy.com/servlet/useragent?func=callWizardwizardKey=salesAgent:1115386861889action=show One member of my Nusing Informatics list asked if it was caused by more manditory data collection, hopefully resulting in more complete documentation. It is partly related with that, but mostly related with poor user-machine interfaces. Sometimes it is just not natural to enter all the information: it is not logically organized, it is dispersed by multiple screens, there are no easy ways to correct errors, etc. See the previous posting about the Role of Computerized Physician Order Entry Systems in Facilitating medication Errors at: http://www.mail-archive.com/openhealth-list%40minoru-development.com/msg11971.html J.A.
Re: Clinical IT increases the time intensive care nurses spend documenting care.
Sure, but the introduction of anasthesia greatly increased the time a surgeon spent doing surgery. It also relieved tremendous suffering and greatly broadened what could be done with surgery as well as improving outcomes dramatically. The VA VistA experience with its dramatic and demonostrable improvement with patient outcomes is an example. A simplistic reply for me to this studies conclusion is: so what? -- IV On Fri, 06 May 2005 10:15:16 +0100 J. Antas [EMAIL PROTECTED] wrote: A study published at the Acta Anaesthesiol Scand. (2005 Jan;49(1):62-5.) documents what seems to be an emerging (and rather unexpected) trend: Clinical IT (HIS) systems increase the time that healthcare workers spend documenting their activities and not the other way around. One could always argue that those systems bring other advantages to the patient and to the care providers, but the fact still remains: they take extra time from the healthcare providers and we should be aware of that. The article Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care?, by Saarinen K, Aho M. of the Department of Intensive Care Medicine, Seinajoki Central Hospital, Seinajoki, Finland, reports: BACKGROUND: The number of intensive care units (ICU) using a clinical information system (CIS) is increasing. It is believed that replacing manual charting with an automatic documentation system allocates nurses more time for patient care. The objective of this study was to measure changes in nurses' working time utilization after the implementation of a CIS in a polyvalent ICU of a large Finnish central hospital. METHODS: An activity analysis-based comparison of the ICU nurses' working time utilization before and after the implementation of a CIS. .../... CONCLUSIONS: After the implementation of a CIS, an increase in the time nurses spent on documentation of care was detected, which suggests a need for further development of the system. As all the measured time changes were relatively small, any plans to reduce the ICU staff number with the aid of computers were not justified. Source URL: http://e-healthexpert.org/node/120 Links: PMID: 15675984 [PubMed - indexed for MEDLINE] , Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care? http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=15675984dopt=Abstract
Re: Clinical IT increases the time intensive care nurses spend documenting care.
That's certainly one way of looking at it! I wonder, is there a demonstrable improvement in quality that can be traced mback to the use of VistA or asnother HIS system. How can this be demonstrated? --- Ignacio Valdes [EMAIL PROTECTED] wrote: Sure, but the introduction of anasthesia greatly increased the time a surgeon spent doing surgery. It also relieved tremendous suffering and greatly broadened what could be done with surgery as well as improving outcomes dramatically. The VA VistA experience with its dramatic and demonostrable improvement with patient outcomes is an example. A simplistic reply for me to this studies conclusion is: so what? -- IV On Fri, 06 May 2005 10:15:16 +0100 J. Antas [EMAIL PROTECTED] wrote: A study published at the Acta Anaesthesiol Scand. (2005 Jan;49(1):62-5.) documents what seems to be an emerging (and rather unexpected) trend: Clinical IT (HIS) systems increase the time that healthcare workers spend documenting their activities and not the other way around. One could always argue that those systems bring other advantages to the patient and to the care providers, but the fact still remains: they take extra time from the healthcare providers and we should be aware of that. The article Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care?, by Saarinen K, Aho M. of the Department of Intensive Care Medicine, Seinajoki Central Hospital, Seinajoki, Finland, reports: BACKGROUND: The number of intensive care units (ICU) using a clinical information system (CIS) is increasing. It is believed that replacing manual charting with an automatic documentation system allocates nurses more time for patient care. The objective of this study was to measure changes in nurses' working time utilization after the implementation of a CIS in a polyvalent ICU of a large Finnish central hospital. METHODS: An activity analysis-based comparison of the ICU nurses' working time utilization before and after the implementation of a CIS. .../... CONCLUSIONS: After the implementation of a CIS, an increase in the time nurses spent on documentation of care was detected, which suggests a need for further development of the system. As all the measured time changes were relatively small, any plans to reduce the ICU staff number with the aid of computers were not justified. Source URL: http://e-healthexpert.org/node/120 Links: PMID: 15675984 [PubMed - indexed for MEDLINE] , Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care? http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=15675984dopt=Abstract A practical man is a man who practices the errors of his forefathers. --Benjamin Disraeli Greg Woodhouse [EMAIL PROTECTED] [EMAIL PROTECTED]
Re: [his-pt] Re: Clinical IT increases the time intensive care nurses spend documenting care.
If the outcome leads to fewer medical errors then some lives and a lot of time can be saved in the long run. Mary At 10:32 06/05/2005 -0500, Ignacio Valdes wrote: Sure, but the introduction of anasthesia greatly increased the time a surgeon spent doing surgery. It also relieved tremendous suffering and greatly broadened what could be done with surgery as well as improving outcomes dramatically. The VA VistA experience with its dramatic and demonostrable improvement with patient outcomes is an example. A simplistic reply for me to this studies conclusion is: so what? -- IV On Fri, 06 May 2005 10:15:16 +0100 J. Antas [EMAIL PROTECTED] wrote: A study published at the Acta Anaesthesiol Scand. (2005 Jan;49(1):62-5.) documents what seems to be an emerging (and rather unexpected) trend: Clinical IT (HIS) systems increase the time that healthcare workers spend documenting their activities and not the other way around. One could always argue that those systems bring other advantages to the patient and to the care providers, but the fact still remains: they take extra time from the healthcare providers and we should be aware of that. The article Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care?, by Saarinen K, Aho M. of the Department of Intensive Care Medicine, Seinajoki Central Hospital, Seinajoki, Finland, reports: BACKGROUND: The number of intensive care units (ICU) using a clinical information system (CIS) is increasing. It is believed that replacing manual charting with an automatic documentation system allocates nurses more time for patient care. The objective of this study was to measure changes in nurses' working time utilization after the implementation of a CIS in a polyvalent ICU of a large Finnish central hospital. METHODS: An activity analysis-based comparison of the ICU nurses' working time utilization before and after the implementation of a CIS. .../... CONCLUSIONS: After the implementation of a CIS, an increase in the time nurses spent on documentation of care was detected, which suggests a need for further development of the system. As all the measured time changes were relatively small, any plans to reduce the ICU staff number with the aid of computers were not justified. Source URL: http://e-healthexpert.org/node/120 Links: PMID: 15675984 [PubMed - indexed for MEDLINE] , Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care? http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=15675984dopt=Abstract = Mary Sharp, B.Sc(Comp), M.A., CEng MIEI, F.I.C.S. Chartered Engineer Lecturer/Tutor Course Director - B.Sc Computer Science Dept. Computer Science Room G36 O'Reilly Institute Trinity College Dublin 2 URL: http://www.cs.tcd.ie/ Telephone +353-1-608-2732 FAX +353-1-677-2204
Re: Clinical IT increases the time intensive care nurses spend documenting care.
AFAIK there hasn't been any real research completed on this, yet. There is a study that has been funded by CIHR (http://www.cihr-irsc.gc.ca/) but is just getting underway that directly addresses the issue of whether or not information technology (specifically electronic medical records) improves patient care. They are recruiting clinics in British Columbia for the three arms of the study. You can get more details about the ICE study at: http://www.path.ubc.ca/studies/ Cheers, Tim On Fri, 2005-05-06 at 09:29, Greg Woodhouse wrote: That's certainly one way of looking at it! I wonder, is there a demonstrable improvement in quality that can be traced mback to the use of VistA or asnother HIS system. How can this be demonstrated? --- Ignacio Valdes [EMAIL PROTECTED] wrote: Sure, but the introduction of anasthesia greatly increased the time a surgeon spent doing surgery. It also relieved tremendous suffering and greatly broadened what could be done with surgery as well as improving outcomes dramatically. The VA VistA experience with its dramatic and demonostrable improvement with patient outcomes is an example. A simplistic reply for me to this studies conclusion is: so what? -- IV On Fri, 06 May 2005 10:15:16 +0100 J. Antas [EMAIL PROTECTED] wrote: A study published at the Acta Anaesthesiol Scand. (2005 Jan;49(1):62-5.) documents what seems to be an emerging (and rather unexpected) trend: Clinical IT (HIS) systems increase the time that healthcare workers spend documenting their activities and not the other way around. One could always argue that those systems bring other advantages to the patient and to the care providers, but the fact still remains: they take extra time from the healthcare providers and we should be aware of that. The article Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care?, by Saarinen K, Aho M. of the Department of Intensive Care Medicine, Seinajoki Central Hospital, Seinajoki, Finland, reports: BACKGROUND: The number of intensive care units (ICU) using a clinical information system (CIS) is increasing. It is believed that replacing manual charting with an automatic documentation system allocates nurses more time for patient care. The objective of this study was to measure changes in nurses' working time utilization after the implementation of a CIS in a polyvalent ICU of a large Finnish central hospital. METHODS: An activity analysis-based comparison of the ICU nurses' working time utilization before and after the implementation of a CIS. .../... CONCLUSIONS: After the implementation of a CIS, an increase in the time nurses spent on documentation of care was detected, which suggests a need for further development of the system. As all the measured time changes were relatively small, any plans to reduce the ICU staff number with the aid of computers were not justified. Source URL: http://e-healthexpert.org/node/120 Links: PMID: 15675984 [PubMed - indexed for MEDLINE] , Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care? http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=15675984dopt=Abstract A practical man is a man who practices the errors of his forefathers. --Benjamin Disraeli Greg Woodhouse [EMAIL PROTECTED] [EMAIL PROTECTED] -- Tim Cook Key ID 0203DEEC @ http://www.keyserver.net http://keyserver.mine.nu Get the key from: http://24.85.34.168:28080/Nikki_and_Tim/twcook_publickey.txt/file_view signature.asc Description: This is a digitally signed message part
Re: Clinical IT increases the time intensive care nurses spend documenting care.
There is the classic David Bates article in JAMA that showed a 50% decrease in medication prescribing errors using a CPOE. I've seen a report but can't produce it right this second that shows that VA prescribing errors are near zero. -- IV On Fri, 06 May 2005 09:51:03 -0700 Tim Cook [EMAIL PROTECTED] wrote: AFAIK there hasn't been any real research completed on this, yet. There is a study that has been funded by CIHR (http://www.cihr-irsc.gc.ca/) but is just getting underway that directly addresses the issue of whether or not information technology (specifically electronic medical records) improves patient care. They are recruiting clinics in British Columbia for the three arms of the study. You can get more details about the ICE study at: http://www.path.ubc.ca/studies/ Cheers, Tim On Fri, 2005-05-06 at 09:29, Greg Woodhouse wrote: That's certainly one way of looking at it! I wonder, is there a demonstrable improvement in quality that can be traced mback to the use of VistA or asnother HIS system. How can this be demonstrated? --- Ignacio Valdes [EMAIL PROTECTED] wrote: Sure, but the introduction of anasthesia greatly increased the time a surgeon spent doing surgery. It also relieved tremendous suffering and greatly broadened what could be done with surgery as well as improving outcomes dramatically. The VA VistA experience with its dramatic and demonostrable improvement with patient outcomes is an example. A simplistic reply for me to this studies conclusion is: so what? -- IV On Fri, 06 May 2005 10:15:16 +0100 J. Antas [EMAIL PROTECTED] wrote: A study published at the Acta Anaesthesiol Scand. (2005 Jan;49(1):62-5.) documents what seems to be an emerging (and rather unexpected) trend: Clinical IT (HIS) systems increase the time that healthcare workers spend documenting their activities and not the other way around. One could always argue that those systems bring other advantages to the patient and to the care providers, but the fact still remains: they take extra time from the healthcare providers and we should be aware of that. The article Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care?, by Saarinen K, Aho M. of the Department of Intensive Care Medicine, Seinajoki Central Hospital, Seinajoki, Finland, reports: BACKGROUND: The number of intensive care units (ICU) using a clinical information system (CIS) is increasing. It is believed that replacing manual charting with an automatic documentation system allocates nurses more time for patient care. The objective of this study was to measure changes in nurses' working time utilization after the implementation of a CIS in a polyvalent ICU of a large Finnish central hospital. METHODS: An activity analysis-based comparison of the ICU nurses' working time utilization before and after the implementation of a CIS. .../... CONCLUSIONS: After the implementation of a CIS, an increase in the time nurses spent on documentation of care was detected, which suggests a need for further development of the system. As all the measured time changes were relatively small, any plans to reduce the ICU staff number with the aid of computers were not justified. Source URL: http://e-healthexpert.org/node/120 Links: PMID: 15675984 [PubMed - indexed for MEDLINE] , Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care? http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=15675984dopt=Abstract A practical man is a man who practices the errors of his forefathers. --Benjamin Disraeli Greg Woodhouse [EMAIL PROTECTED] [EMAIL PROTECTED] -- Tim Cook Key ID 0203DEEC @ http://www.keyserver.net http://keyserver.mine.nu Get the key from: http://24.85.34.168:28080/Nikki_and_Tim/twcook_publickey.txt/file_view
Re: Clinical IT increases the time intensive care nurses spend documenting care.
J. Antas wrote: A study published at the Acta Anaesthesiol Scand. (2005 Jan;49(1):62-5.) documents what seems to be an emerging (and rather unexpected) trend: Clinical IT (HIS) systems increase the time that healthcare workers spend documenting their activities and not the other way around. One could always argue that those systems bring other advantages to the patient and to the care providers, but the fact still remains: they take extra time from the healthcare providers and we should be aware of that. Be careful here: it depends on what systems, how they were used, what information was captured (versus what used to be captured on paper) and many other factors. Including how the study was done. I just reviewed four finalist papers for inclusion in the EHR section of the IMIA yearbook 2005, and none reported this trend; from memory 2 reported the reverse trend, and all reported better quality in some form. - thomas beale
