Omar Lena A, King Richard V, Pease John, Omar Hythem A
Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8896, Dallas, TX 75390, USA.
Health Care Sciences/Emergency Medicine Education, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 9134, Dallas, TX 75390, USA.
J Clin Med Res. 2014 Aug;6(4):267-71. doi: 10.14740/jocmr1821w. Epub 2014 May 22.
To determine the impact of a radiology electronic notification system (ENS) on emergency department (ED) patient care.
A retrospective review of de-identified patient data for a 2-year period (1 year prior to and 1 year following ENS implementation) was approved by the hospital's institutional review board. The effect of a radiology ENS on ED patient care was investigated by analyzing the intervals between completion of a chest radiograph and the times antibiotics were ordered/administered on patients presenting with symptoms of community acquired pneumonia (CAP). The square root transformation of the means was analyzed with an ANOVA model to determine statistical significance.
During the 24-month study protocol, 1,341 patients who were evaluated in the ED met the study eligibility criteria. The least square estimates of the mean times from when the chest radiograph was completed to when antibiotics were ordered prior to and after the implementation of the ENS were 89 and 107 minutes, respectively (P < 0.01). The least square estimates of the mean times from when the chest radiograph was completed to when antibiotics were administered prior to and after the implementation of the ENS were 115 and 132 minutes, respectively (P = 0.02).
The implementation of a radiology ENS does have advantages for the radiologist in streamlining the communication and documentation processes but may negatively impact time to treatment and thus patient care.
确定放射学电子通知系统(ENS)对急诊科(ED)患者护理的影响。
对2年期间(ENS实施前1年和实施后1年)去识别化的患者数据进行回顾性审查,该审查获得了医院机构审查委员会的批准。通过分析胸部X光检查完成时间与为社区获得性肺炎(CAP)症状患者开具/使用抗生素时间之间的间隔,研究放射学ENS对ED患者护理的影响。使用方差分析模型分析均值的平方根变换以确定统计学意义。
在为期24个月的研究方案中,在ED接受评估的1341名患者符合研究纳入标准。ENS实施前后,从胸部X光检查完成到开具抗生素的平均时间的最小二乘估计分别为89分钟和107分钟(P < 0.01)。ENS实施前后,从胸部X光检查完成到使用抗生素的平均时间的最小二乘估计分别为115分钟和132分钟(P = 0.02)。
放射学ENS的实施确实对放射科医生简化沟通和记录流程有优势,但可能对治疗时间产生负面影响,从而对患者护理产生负面影响。