Vanderbilt University School of Medicine, Nashville, TN, United States of America.
Vanderbilt University Medical Center, Department of Neurology, Nashville, TN, United States of America.
Am J Emerg Med. 2020 Jan;38(1):114-117. doi: 10.1016/j.ajem.2019.07.017. Epub 2019 Jul 11.
Emergency department (ED) providers and clinicians find that feedback on acute stroke patients is rewarding, valuable to professional development, and helpful for practice improvement. However, feedback is rarely provided, particularly for patients with stroke. Here we describe the implementation of an electronic stroke outcome reporting tool for providing feedback to ED providers.
We sought to evaluate the implementation of an electronic stroke outcome reporting tool at 3 Nashville hospitals. ED staff and providers voluntarily enrolled to receive de-identified reports of clinical (e.g., survival) and operational (e.g., timeliness) outcomes of patients with acute ischemic stroke and were offered free continuing education (CE) credits for following up on patients. We evaluated the implementation of this system through a descriptive evaluation of the feasibility, use of the system and CE, and perceived usefulness of the reports.
We enrolled 232 ED providers, including 107 (46%) nurses and 57 (25%) attending physicians and transmitted 55 stroke outcome reports. Reports took 30-60 min to compile and were viewed by a mean of 2.6 (SD 1.5) registered providers; 97.1% found the reports useful and 36.2% reported likelihood to change practice. Continuing education credits were initiated or claimed by 22 providers.
An electronic stroke outcome reporting tool was used and liked by ED staff and providers but the time to compile the reports is the major challenge to scalability. Future research should address the effectiveness of this reporting tool as a source of provider education and its impact on clinical and operational outcomes.
急诊（ED）医护人员和临床医生发现，对急性脑卒中患者的反馈是有益的，对专业发展有价值，有助于改善实践。然而，反馈很少提供，尤其是对脑卒中患者。在此，我们介绍一种用于向 ED 医护人员提供反馈的电子脑卒中结局报告工具的实施情况。
我们旨在评估在纳什维尔的 3 家医院实施电子脑卒中结局报告工具的情况。ED 工作人员和医护人员自愿登记，以接收急性缺血性脑卒中患者的临床（如存活）和操作（如及时性）结局的匿名报告，并提供免费的继续教育（CE）学分，以对患者进行随访。我们通过对该系统的可行性、使用情况和 CE、报告的实用性进行描述性评估，来评估该系统的实施情况。
我们共招募了 232 名 ED 医护人员，包括 107 名（46%）护士和 57 名（25%）主治医生，并传输了 55 份脑卒中结局报告。报告的编制时间为 30-60 分钟，平均有 2.6 名（SD 1.5）注册医护人员查看；97.1%的人认为报告有用，36.2%的人表示可能会改变实践。有 22 名医护人员启动或声称已获得 CE 学分。
ED 工作人员和医护人员使用并喜欢电子脑卒中结局报告工具，但报告编制时间是可扩展性的主要挑战。未来的研究应探讨该报告工具作为医护人员教育的来源的有效性及其对临床和操作结局的影响。
