Evans R S, Olson J A, Stenehjem E, Buckel W R, Thorell E A, Howe S, Wu X, Jones P S, Lloyd J F
Medical Informatics, Intermountain Healthcare, University of Utah , Salt Lake City, Utah ; Biomedical Informatics, University of Utah, University of Utah , Salt Lake City, Utah.
Pharmacy, Primary Children's Medical Center, University of Utah , Salt Lake City, Utah.
Appl Clin Inform. 2015 Mar 3;6(1):120-35. doi: 10.4338/ACI-2014-11-RA-0102. eCollection 2015.
Document information needs, gaps within the current electronic applications and reports, and workflow interruptions requiring manual information searches that decreased the ability of our antimicrobial stewardship program (ASP) at Intermountain Healthcare (IH) to prospectively audit and provide feedback to clinicians to improve antimicrobial use.
A framework was used to provide access to patient information contained in the electronic medical record, the enterprise-wide data warehouse, the data-driven alert file and the enterprise-wide encounter file to generate alerts and reports via pagers, emails and through the Centers for Diseases and Control's National Healthcare Surveillance Network.
Four new applications were developed and used by ASPs at Intermountain Medical Center (IMC) and Primary Children's Hospital (PCH) based on the design and input from the pharmacists and infectious diseases physicians and the new Center for Diseases Control and Prevention/National Healthcare Safety Network (NHSN) antibiotic utilization specifications. Data from IMC and PCH now show a general decrease in the use of drugs initially targeted by the ASP at both facilities.
To be effective, ASPs need an enormous amount of "timely" information. Members of the ASP at IH report these new applications help them improve antibiotic use by allowing efficient, timely review and effective prioritization of patients receiving antimicrobials in order to optimize patient care.
记录信息需求、当前电子应用程序和报告中的差距，以及需要手动搜索信息导致工作流程中断的情况，这些中断降低了山间医疗保健公司（IH）抗菌药物管理计划（ASP）对临床医生进行前瞻性审核并提供反馈以改善抗菌药物使用的能力。
使用一个框架来访问电子病历、企业级数据仓库、数据驱动警报文件和企业级诊疗文件中包含的患者信息，通过寻呼机、电子邮件以及疾病控制中心的国家医疗保健监测网络生成警报和报告。
基于药剂师和传染病医生的设计与投入以及疾病控制与预防中心/国家医疗保健安全网络（NHSN）新的抗生素使用规范，山间医疗中心（IMC）和 Primary Children's Hospital（PCH）的 ASP 开发并使用了四个新应用程序。IMC 和 PCH 的数据现在显示，这两个机构中最初由 ASP 针对的药物使用普遍减少。
为了有效，ASP 需要大量“及时”的信息。IH 的 ASP 成员报告称，这些新应用程序通过允许对接受抗菌药物治疗的患者进行高效、及时的审查和有效排序，帮助他们改善抗生素使用，从而优化患者护理。
