电子健康记录的实施和使用对手术护理改善项目措施绩效的影响。
The impact of electronic health record implementation and use on performance of the Surgical Care Improvement Project measures.
机构信息
Department of Public Health Sciences, University of Rochester, Rochester, NY.
出版信息
Health Serv Res. 2015 Feb;50(1):273-89. doi: 10.1111/1475-6773.12191. Epub 2014 Jun 26.
Abstract
OBJECTIVE
To examine the impact of electronic health record (EHR) deployment on Surgical Care Improvement Project (SCIP) measures in a tertiary-care teaching hospital.
DATA SOURCES
SCIP Core Measure dataset from the CMS Hospital Inpatient Quality Reporting Program (March 2010 to February 2012).
STUDY DESIGN
One-group pre- and post-EHR logistic regression and difference-in-differences analyses.
PRINCIPAL FINDINGS
Statistically significant short-term declines in scores were observed for the composite, postoperative removal of urinary catheter and post-cardiac surgery glucose control measures. A statistically insignificant improvement in scores for these measures was noted 3 months after EHR deployment.
CONCLUSION
The transition to an EHR appears to be associated with a short-term decline in quality. Implementation strategies should be developed to preempt or minimize this initial decline.
摘要
目的
在一家三级教学医院中，考察电子健康记录（EHR）的部署对外科护理改善计划（SCIP）措施的影响。
资料来源
CMS 医院住院患者质量报告计划（2010 年 3 月至 2012 年 2 月）中的 SCIP 核心措施数据集。
研究设计
一组在 EHR 部署前后进行的逻辑回归和差异分析。
主要发现
术后尿管去除和心脏手术后血糖控制措施的综合评分、术后尿管去除和心脏手术后血糖控制措施的得分都出现了统计学上的短期下降。在 EHR 部署 3 个月后，这些措施的得分有了统计学上的显著提高。
结论
向 EHR 的过渡似乎与短期质量下降有关。应制定实施策略来预防或尽量减少这种初始下降。
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