Introduction Medical and medication errors and adverse events are well known issues in the health care industry, regardless of country. Errors are either the correct implementation of the wrong procedure or the wrong implementation of the correct procedure (IOM, 1999 pp23-25). Adverse events are considered unintended injuries and/or harm that are caused to the patient but not necessarily due to human error. This proposal will present a technical solution, using case based reasoning, to help prevent the occurrence of errors, thus reduce adverse events, and to make suggestions to the line staff as to what to do when such an event or error happens. Purpose and Goals One of many nationwide initiatives to help reduce the occurrence of unnecessary medical errors and adverse events is the use of the integrated Clinical Decision Support System (CDSS). A CDSS is a system that provides the right information to the right person in a right format through a right channel at the right time of workflow to facilitate better decision-making by clinicians, reduce errors, and also to prevent adverse events (AHRQ, 2008). This proposal is a case based CDSS system that provides point of care clinical decision support, ensures five rights of medication administration (right person, right drug, right dose, right time and right route), and is designed to prevent or reduce the occurrence errors and adverse events at Perpetual Order of Saints Hospital (POSH). The case based reasoning system proposed here mimics the human decision making process by learning from previous experience and using the knowledge to solve current problem. This system will utilize previous adverse episodes and their solutions to prevent reoccurrences, and also to detect the oc... ... middle of paper ... ...3) Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. Journal of American Medical Informatics Association 10(6): 523-530. Friedman, L. N., Halpern, N. A. & Fackler, J.C. (2007). Implementing an Electronic Medical Record. Critical Care Clinics 23: 347-381. Gong, Y. (2010). Case-based Medical reasoning. HMI 8571 Decision Support Systems in Healthcare. Feb 22, 2010. Retrieved on 2/22/10 https://hmi.missouri.edu/moodle/mod/resource/view.php?id=11201 Hauan, M.J. (2004). Decision Support Methods. HMI 471. Retrieved from on 2/15/10. https://hmi.missouri.edu/moodle/mod/resource/view.php?id=11201 Kohn, L., Corrigan, J., & Donaldson, M. (1999). To err is human: building a safer health system. Committee on Quality of Health Care in America Institute of Medicine National Academy Press Washington, D.C.
In conclusion, clinical decision support systems provide a mechanism for improving the quality of care services when integrated with evidence-based practice and clinical guidelines. These systems would particularly improve health care quality when combined with evidence-based medicine. This process may also include the use of databases and condition-specific clinical guidelines to improve their effectiveness and efficiency.
Jha, A. K., Burke, M. F., DesRoches, C., Joshi M. S., Kralovec P. D., Campbell E. G., & Buntin M. B. (2011). Progress Toward Meaningful Use: Hospitals’ Adoption of Electronic Health Records. The American Journal of Managed Care, 17, 117-123
The purpose of this paper is to discuss how Electronic Medical Records (EMR), affects healthcare delivery. I will discuss the positives and negatives this issue has on healthcare and how it effects the cost and quality for healthcare services. In addition, I will identify any potential trade-offs to cost or quality. Lastly, I will discuss how the EMR affects my job as well as any challenges or opportunities this issue presents.
The implementation of the Clinical Decision Support System (CDSS) was to allow physicians the ability diagnoses patients with the use of evidence based decisions. Physicians can explore relevant medical information through the CDSS from reliable medical experts, clinical guideline extractions and alerts of new and different phases of patient management without the interruption of the medical organization’s workflow (Chiarugi, Colantonio, Emmanouili...
According to Poorolajal, medical errors occur when health care providers choose inappropriate methods of care or improperly execute an appropriate method of care (Poorolajal, et al. para 5 -10), which could potentially lead to loss of life and severe or permanent trauma to the victim. Valiani et al. argues, “Committing an error is part of the human nature” (540). Valiani et al. insist that no health care practitioner is immune to committing an error event if they demonstrate mastery of their skills (540). However, error in health care systems is dependent on many causes and factors. Management of such factors is essential to reducing the occurrence of errors in a health care system. Therefore, what strategies can medical practitioners implement to reduce medical errors? Medical practitioners can implement strategies such as communication, verification, and eliminating extended work shifts. These strategies are most effective because they help medical providers fulfill their full potential in doing their job in the most effective
Elvis had many comorbid symptoms during his lifetime. Firstly, Elvis had issues with substance abuse. When he was in between appearances and shows he struggled to find a way to handle with a less hectic lifestyle. His autopsy revealed that he had at least fourteen different drugs in his blood stream. Starting around the time he was enlisted in the army, Elvis slowly began to take uppers to give him energy. When it was time to settle down, he would take sleeping aids such as Ethinamate (Romano, 2014).
A major component of clinical decision support system is it helps locate and prevent errors made by many providers. Other components of a clinical decision- support system are speed- this can make or break at system, it is very annoying if you have to set and wait for the system to perform a simple function as looking up information, the need and delivery of real time- if there is lag time and the information needed doesn’t appear in seconds it can pose as the system is not performing up to par, fit of the users work –flow- the alerts, guidelines, and algorithms need to be in place so there are no confusions when a users are dispersing medications, usability- this makes a tremendous difference in how a system performs many clinician want to be able to use a computer system with ease, if the system is to complicated it can appear as not user friendly, being aware that there will be resistances from the provider- offend many providers will give pushback on changing there mind without input as to way a change is required; for example should x-rays be taking on all patients with abdomen pain, approximately five percent of physician actually went with the recommendation of not ordering x-rays on patie...
Encinosa, W. E., & Jaeyong, B. (2013). Will Meaningful Use Electronic Medical Records Reduce Hospital Costs?. American Journal Of Managed Care, 19eSP19-eSP25.
Boaden, R., & Joyce, P. (2006). Developing the electronic health record: What about patient safety? Health Services Management Research, 19 (2), 94-104. Retrieved from http://search.proquest.com/docview/236465771?accountid=32521
Over the last several years, electronic medical records are becoming more prominent in health care facilities, replacing traditional written records. As many electronics are becoming more prevalent with the invention of numerous smartphones and tablet devices, it seems that making medical records available electronically would be appropriate for the evolving times. Even though they have been in use to some extent for many years, the “Health Information Technology for Economic and Clinical Health section of the American Recovery and Reinvestment Act has brought paperless documentation into the spotlight” (Eisenberg, 2010, p. 8). The systems of electronic medical records mainly consist of clinical note taking, prescription and medication documentation,
The purpose of the Electronic Health Record is to provide a comprehensive, standardized and universal digital version of a patient 's health records. The availability of a patient 's digital health record provides health information and data for critical thinking and evidence based decision-making, aggregates patient data for quality assurance and research. The Electronic Health Record has been, "identified as a strategy for effectively and efficiently coordinating and maintaining documentation of patients health histories and as a secure method of providing more informed clinical decision making" (MNA, 2006).
An error can happen at any step of the process. The Institute for Safe Medication Practices has identified ten elements with the greatest influence on medication error such as, two patient identifiers, ask the patient about any allergy, Avoid abbreviations, pay close attention to patient’s diagnosis, and note the patient current medication regimen. Using two identifiers when dispensing medication can cut the risk of medication errors. For example, along with patient’s name ask for the date of birth to make sure the prescription matches the patient. In addition, having a system in place to show patients with similar names. This can be simple as a special color coded stickers or even verify information with the family members. Secondly, ask the patient about any allergy and reaction to medications before any new medication is administered. This includes information from the patient’s chart. Thirdly avoid the use of abbreviations which can easily misinterpret when documenting medication of allergies. Fourthly, pay close attention to the patient’s diagnosis, which can affect the dose and frequency. For instance, patients with kidney, impairment, liver and diabetes fall under this category. Educate patients to ask for information from their doctor when they received a medication to include what is the name of the medicine, dosage, and what it is used for. Lastly, note the patient’s current medication regimens and update the list for each visit. These simple tips can definitely enhance patient safety and decrees any
It is shocking to know that every year 98000 patients die from medical errors that can be prevented(Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.), 2000). Medical errors are not a new issue in our healthcare system; these have been around for a long time. Hospitals have been trying to improve quality care and patients safety by implementing different strategies to prevent and reduce medical errors for past thirty years. Medical errors are the third leading cause of death after heart disease and cancer in America (Allen, 2013). In addition medical errors are costing our healthcare system an estimated $735 billion to $980 billion (Andel, Davidow, Hollander, & Moreno, 2012).
Our clinical knowledge is expanding. The researcher has first proposed the concept of electronic health record (EHR) to gather and analyze every clinical outcome. By late 1990s computer-based patient record (CPR) replaced with the term EHR (Wager et al., 2009). The process of implementing EHR occurs over a number of years. An electronic record of health-related information on individual conforms interoperability standards can create, manage and consult with the authorized health professionals (Wager et al., 2009). This information technology system electronically gather and store patient data, and supply that information as needed to the healthcare professionals, as well as a caregiver can also access, edit or input new information; this system function as a decision support tools to the health professionals. Every healthcare organization is increasingly aware of the importance of adopting EHR to improve the patient satisfaction, safety, and lowering the medical costs.
Quality of care in healthcare was not previously measured or reported due to the ultimate trust that patients had in their care providers that what was prescribe or treatment given was necessary and appropriate. As society has evolved healthcare has undergone changes that has significant impacted the way in which healthcare is practiced. A landmark in the quality movement in health care has been the publication of the Institute of Medicine 's (IOM) report “To err is human: building a safer health system” of 1993, which serve to usher in an era of care focused on improving quality, and ultimately a culture of evidence-based care (De Jonge, Nicolaas, Van Leerdam & Kuipers, 2011).