Improving Staff Compliance with an Emergency Department Intranet

使用急診內部網路以增進醫護人員順從性之探討

廖訓禎(Shiumn-Jen Liaw) ； 卜樂得(Michael J. Bullard) ； 胡百敏(Pai-Min Hu) ； 陳日昌(Jih-Chang Chen) ； 廖浩欽(How-Chin Liao) ； 李佳琳(Chia-Lin Li)

《中華民國急救加護醫學會雜誌》 11卷4期 (2000/12) Pp. 144-150

https://doi.org/10.30018/JECCM.200012.0002

摘要

This study evaluated the effect of personnel and procedural changes in improving emergency depart-ment (ED) computer utilization. The investigation was a retrospective database review. Patients present-ing to a 3,500 bed tertiary care center ED for the pre-and post-intervention periods, July to December 1994 and 1996 were compared for compliance and data entry accuracy. Four hundred randomly selected cases were then chosen from each time period and the charts and computer entries reviewed for concor-dance. Interventins included: (1) adding a clerk to assist in data entry; (2) adding keystroke requests to simplity nursing work; and (3) using computer log data as objective measures for physician-in-training evaluations. The overall key-in rate rose from 58.3% in 1994 to 87.5% (p＜0.001) in 1996. Vital signs accuracy improved from a mean of 86.5% to 92.4% (p＜0.05). Concordance between the chart and com-puter ED diagnoses were 94.5% in 1994 and 97% (p=0.079) in 1996 and for chief complaint improved from 96.8% to 99% (p=0.027). Completion of patient dispositions following the addition of the clerk rose from 60% to 89.3% (p＜0.001). Computerized patient tracking was clearly enhanced by the addition of a clerk to monitor and assist in data entry. Including an extended ED patient log as a measure of education-al performance appeared to increase compliance in parallel.

關鍵字

急診部門 ； 賽部網路 ； 電腦 ； 順從性 ； 追蹤系統

並列摘要

This study evaluated the effect of personnel and procedural changes in improving emergency depart-ment (ED) computer utilization. The investigation was a retrospective database review. Patients present-ing to a 3,500 bed tertiary care center ED for the pre-and post-intervention periods, July to December 1994 and 1996 were compared for compliance and data entry accuracy. Four hundred randomly selected cases were then chosen from each time period and the charts and computer entries reviewed for concor-dance. Interventins included: (1) adding a clerk to assist in data entry; (2) adding keystroke requests to simplity nursing work; and (3) using computer log data as objective measures for physician-in-training evaluations. The overall key-in rate rose from 58.3% in 1994 to 87.5% (p＜0.001) in 1996. Vital signs accuracy improved from a mean of 86.5% to 92.4% (p＜0.05). Concordance between the chart and com-puter ED diagnoses were 94.5% in 1994 and 97% (p=0.079) in 1996 and for chief complaint improved from 96.8% to 99% (p=0.027). Completion of patient dispositions following the addition of the clerk rose from 60% to 89.3% (p＜0.001). Computerized patient tracking was clearly enhanced by the addition of a clerk to monitor and assist in data entry. Including an extended ED patient log as a measure of education-al performance appeared to increase compliance in parallel.

並列關鍵字

emergency department ； intranet ； computer ； compliance ； tracking system