Search results for "Hospitals"

Communication breakdowns in the operating room are associated with preventable adverse events. This study examined the potential of a novel workflow management system—a computerized system which used voice recognition and built-in algorithms to ensure important procedural steps were undertaken appropriately—to improve patient safety. The system was able to detect when intraoperative tasks were being performed and successfully identified omitted steps as well.

Checklists can reduce risks of cognitive gaps that contribute to errors in health care. This commentary uses case studies to illustrate the potential value of an open-access online diagnostic checklist in neurological care to help physicians determine diagnoses.

Implementation of smart intravenous pumps was associated with fewer adverse events and considerable cost savings at an academic medical center.

This newspaper article reports how one hospital system introduced advanced training programs to ensure safe use of surgical robots.

This newspaper article discusses complications associated with surgical robots, and explains that such errors may have been exacerbated by inadequate clinician training and production pressures.

Clinician decision support systems (CDSS) hold great promise as a means of promoting appropriate care, reducing diagnostic errors, and minimizing medication prescribing errors. However, a recent systematic review found that, taken as a whole, decision support systems achieved only small changes in provider behavior. In this study, a custom-designed CDSS that focused on preventing excessive medication dosages was implemented within a computerized provider order entry system, and resulted in a significant reduction in prescribing errors. Clinicians accepted one in four of the CDSS warnings—a seemingly low proportion that is, in fact, much higher than response rates found in many prior studies of drug alert warnings. The system was carefully tailored to be integrated into provider workflow and to provide only patient-specific warnings, factors that likely contributed to its success.

This study found that use of an integrated operating room (OR) system and a digital checklist tool reduced risk-sensitive events more than using an integrated OR alone.

Adoption of smart infusion pump technology was intended to improve medication safety, but past reports describe the ability of nurses to create work-arounds. This study examined preventable intravenous adverse drug events (IV-ADEs) and discovered that only 4% could be intercepted by a smart pump. Investigators reviewed medical records, both before and after adoption of smart pumps, to draw these conclusions. They also provide a qualitative analysis of errors causing preventable IV-ADEs and propose solutions that would improve smart pump technology.

This article describes how robust drug libraries developed for programmable smart pumps can help reduce medication errors associated with traditional infusion methods.

The researchers performed a comparative cost analysis between a paper-based medication ordering and administration process and an electronic system and found that the online system had the potential to cut costs and reduce adverse drug events.

The author discusses approaches to improving safety in the operating room, such as the use of robotics and simulation.

The authors conducted focus groups to assess nurses' experiences with using smart pumps and the ways in which they overcame challenges associated with this technology.

The authors suggest a model process utilizing failure mode and effects analysis to effectively implement emerging technologies that help minimize medication error.

The authors describe the implementation of intravenous medication administration software interfaced with "smart" infusion pumps.

An intern increases a patient's warfarin dosage nightly based on subtherapeutic INR levels drawn each morning; after several days, the patient develops potentially life-threatening bleeding.

New technology continues to offer great advances and challenges. This article takes a detailed look at technology's impact on human performance by studying the implementation of a new physiological monitoring system for use in cardiac anesthesia. Discussion includes characteristics of the upgraded system, a process-tracing technique to examine the complex physician-computer interaction, and the problems that developed while in use. The authors introduce a number of new cognitive burdens that resulted and discuss how providers attempted to overcome these burdens within the framework of the new system. Though it represents one example, the rich discussion in this article applies to most new technology and the human factors that require it to function as technically designed.