Aseem SayedObaidullah, Ratrout Basem M, Litin Scott C, Ganesh Ravindra, Croghan Ivana T, Salerno Matthew S, Majka Andrew J, Chutka Darryl S, Hurt Ryan T, Abu Lebdeh Haitham S, Vincent Ann, Nanda Sanjeev
Clinician-Investigator Training Program, Mayo Clinic, Rochester, MN.
Executive, Development, and International Medicine Program, Mayo Clinic, Rochester, MN.
Mayo Clin Proc Innov Qual Outcomes. 2020 Jan 8;4(1):99-104. doi: 10.1016/j.mayocpiqo.2019.10.002. eCollection 2020 Feb.
Appropriate patient identification is a critical component of safe health care delivery. With increasing reliance on electronic medical records (EMRs), errors of test ordering and documentation have become commonplace. Incorporating patients' photograph in the EMR has considerably decreased error frequency and improved health care delivery by making it easier for physicians to identify a patient. We conducted a survey of all 35 physicians working in the Executive Health Program to determine the importance of having patient photographs in the EMR. Of the 35 physicians who received the survey, 26 (74.3%) responded, 24 (92.3%) of whom agreed that it was important to improve patient identification, care, and safety. Based on these data, we implemented a quality improvement project to increase the percentage of new patients having a photograph included in the EMR. Our goal was to increase photograph inclusion by more than 20% from baseline within 6 months without any unintended consequences (ie, not slowing down any of the workflow during the intake process). The intervention took place between June 1, 2015, and February 8, 2016. Using Define-Measure-Analyze-Improve-Control models, the baseline rate of photographs in the EMR was 49.5% (302 of 607). We initiated 3 Plan-Do-Study-Act cycles targeting awareness and data sharing campaigns. After the Plan-Do-Study-Act cycles, the weekly rate of patient photographs incorporated into the EMR was at 71.4%, which was significantly improved compared with baseline (F test, <.001). No unintended consequences were identified. Increased inclusion of patient photographs in the EMR aided in patient identification and improved staff satisfaction with minimal interruption to workflow.
准确识别患者是安全提供医疗服务的关键要素。随着对电子病历（EMR）的依赖日益增加，检验医嘱和记录方面的错误已变得很常见。在电子病历中纳入患者照片，通过让医生更容易识别患者，已大幅降低了错误发生率并改善了医疗服务。我们对在高级健康项目中工作的所有35名医生进行了一项调查，以确定电子病历中包含患者照片的重要性。在收到调查的35名医生中，26名（74.3%）做出了回应，其中24名（92.3%）同意改善患者识别、护理和安全很重要。基于这些数据，我们实施了一项质量改进项目，以提高电子病历中包含照片的新患者比例。我们的目标是在6个月内将照片纳入率比基线提高20%以上，且不产生任何意外后果（即不会在接诊过程中减缓任何工作流程）。干预措施于2015年6月1日至2016年2月8日期间实施。使用定义-测量-分析-改进-控制模型，电子病历中照片的基线率为49.5%（607例中的302例）。我们启动了3个计划-实施-研究-行动周期，目标是开展提高认识和数据共享活动。经过计划-实施-研究-行动周期后，纳入电子病历的患者照片每周率达到71.4%，与基线相比有显著改善（F检验，<.001）。未发现任何意外后果。电子病历中增加患者照片的纳入有助于患者识别，并在对工作流程干扰最小的情况下提高了工作人员的满意度。
