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迈向全国围手术期结局登记系统:澳大利亚和新西兰麻醉医师学院临床试验网络在澳大利亚的医院中围手术期电子病历使用情况的调查,以支持质量保证和研究。

Towards a national perioperative outcomes registry: A survey of perioperative electronic medical record utilisation to support quality assurance and research at Australian and New Zealand College of Anaesthetists Clinical Trials Network hospitals in Australia.

作者信息

Reilly Jennifer R, Deng Carolyn, Brown Wendy A, Brown Dianne, Gabbe Belinda J, Hodgson Carol L, Myles Paul S

机构信息

Department of Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, Australia.

Department of Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, Australia.

出版信息

Anaesth Intensive Care. 2022 May;50(3):189-196. doi: 10.1177/0310057X211030284. Epub 2022 Jan 18.

Abstract

In Australia, 2.7 million surgical procedures are performed annually. Historically, a lack of perioperative data standardisation and infrastructure has limited pooling of routinely collected data across institutions. We surveyed Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network hospitals to investigate current and potential uses of perioperative electronic medical record data for research and quality assurance.A targeted survey was sent to 131 ANZCA Clinical Trials Network-affiliated hospitals in Australia. The primary aim was to map current electronic data collection methods and data utilisation in six domains of the perioperative pathway.The survey response rate was 32%. Electronic data recording in the six domains ranged from 19% to 85%. Where electronic data exist, the ability of anaesthesiology departments to export them for analysis ranged from 27% to 100%. The proportion of departments with access to data exports that are regularly exporting the data for quality assurance or research ranged from 13% to 58%.The existence of a perioperative electronic medical record does not automatically lead to the data being used to measure and improve clinical outcomes. The first barrier is clinician access to data exports. Even when this barrier is overcome, a large gap remains between the proportion of departments able to access data exports and those using the data regularly to inform and improve clinical practice. We believe this gap can be addressed by establishing a national perioperative outcomes registry to lead high-quality multicentre registry research and quality assurance in Australia.

摘要

在澳大利亚,每年进行270万例外科手术。从历史上看,围手术期数据标准化和基础设施的缺乏限制了跨机构常规收集数据的汇总。我们对澳大利亚和新西兰麻醉师学院(ANZCA)临床试验网络医院进行了调查,以研究围手术期电子病历数据在研究和质量保证方面的当前及潜在用途。

向澳大利亚131家隶属于ANZCA临床试验网络的医院发送了有针对性的调查问卷。主要目的是梳理围手术期路径六个领域当前的电子数据收集方法和数据利用情况。

调查回复率为32%。六个领域的电子数据记录率在19%至85%之间。在存在电子数据的情况下,麻醉科将数据导出用于分析的能力在27%至100%之间。能够获取数据导出且定期将数据导出用于质量保证或研究的科室比例在13%至58%之间。

围手术期电子病历的存在并不会自动导致数据被用于衡量和改善临床结果。第一个障碍是临床医生获取数据导出的权限。即使克服了这一障碍,能够获取数据导出的科室比例与经常使用这些数据来指导和改善临床实践的科室比例之间仍存在很大差距。我们认为,可以通过建立一个全国围手术期结果登记处来填补这一差距,以引领澳大利亚高质量的多中心登记研究和质量保证工作。

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