VA Palo Alto Health Care System, Anesthesiology and Perioperative Care Service, Palo Alto, CA, USA.
Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
J Med Syst. 2017 Aug;41(8):118. doi: 10.1007/s10916-017-0762-z. Epub 2017 Jul 6.
Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development. Methods consisted of semi-structured interviews in 2 phases with a diverse set (n = 9) of support personnel and end users from five facilities across a Veterans Integrated Service Network. Phase 1 identified underlying needs and previous experiences with the analytics platform across various roles and operational responsibilities. Phase 2 validated preliminary feedback, lessons learned, and recommendations for improvement. Emerging themes suggested that the existing system met a small pool of national reporting requirements. However, pain points were identified with accessing data in several information system silos and performing multiple manual validation steps of data content. Notable recommendations included enhancing systems integration to create "one-stop shopping" for data, and developing a capability to perform trends analysis. Our gap analysis suggests that analytics platforms designed for surgical and ICU patients should employ approaches similar to those being used for primary care patients.
医疗机构正在实施分析平台,以此来记录医疗服务质量。然而,针对专门为手术室、麻醉后护理单元和重症监护病房 (ICU) 中治疗的患者设计的平台,很少有差距分析。作为质量改进工作的一部分,我们对退伍军人医疗保健管理局内现有的分析平台进行了差距分析。目标是确定与以下内容相关的主题:1)当前临床用例和利益相关者需求;2)信息流和痛点;以及 3)未来分析开发的建议。方法包括在两个阶段进行半结构化访谈,访谈对象是来自退伍军人综合服务网络中的五个设施的一组多样化的支持人员和最终用户(n=9)。第 1 阶段确定了各个角色和运营职责范围内的基础需求以及对分析平台的以往经验。第 2 阶段验证了初步反馈、经验教训和改进建议。出现的主题表明,现有系统满足了一小部分国家报告要求。然而,在访问多个信息系统孤岛中的数据和执行多次手动验证数据内容的步骤时,存在痛点。值得注意的建议包括增强系统集成,为数据创建“一站式服务”,以及开发执行趋势分析的能力。我们的差距分析表明,为手术和 ICU 患者设计的分析平台应采用与用于初级保健患者类似的方法。