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将基于电子健康记录的患者安全算法从研究转化为多个地点的临床实践。

Translating electronic health record-based patient safety algorithms from research to clinical practice at multiple sites.

机构信息

Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey VA Medical Center, Houston, Texas, USA.

Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

出版信息

BMJ Health Care Inform. 2022 Jul;29(1). doi: 10.1136/bmjhci-2022-100565.

Abstract

INTRODUCTION

Researchers are increasingly developing algorithms that impact patient care, but algorithms must also be implemented in practice to improve quality and safety.

OBJECTIVE

We worked with clinical operations personnel at two US health systems to implement algorithms to proactively identify patients without timely follow-up of abnormal test results that warrant diagnostic evaluation for colorectal or lung cancer. We summarise the steps involved and lessons learned.

METHODS

Twelve sites were involved across two health systems. Implementation involved extensive software documentation, frequent communication with sites and local validation of results. Additionally, we used automated edits of existing code to adapt it to sites' local contexts.

RESULTS

All sites successfully implemented the algorithms. Automated edits saved sites significant work in direct code modification. Documentation and communication of changes further aided sites in implementation.

CONCLUSION

Patient safety algorithms developed in research projects were implemented at multiple sites to monitor for missed diagnostic opportunities. Automated algorithm translation procedures can produce more consistent results across sites.

摘要

简介

研究人员越来越多地开发影响患者护理的算法,但算法也必须在实践中实施,以提高质量和安全性。

目的

我们与两家美国医疗系统的临床运营人员合作,实施算法,主动识别没有及时跟进异常检查结果的患者,这些结果需要进行结直肠癌或肺癌的诊断评估。我们总结了所涉及的步骤和经验教训。

方法

两个医疗系统的 12 个站点参与了该研究。实施过程涉及广泛的软件文档、与站点的频繁沟通以及对结果的本地验证。此外,我们还使用现有的代码自动编辑来适应站点的本地环境。

结果

所有站点都成功实施了算法。自动编辑为站点在直接代码修改方面节省了大量工作。更改的文档和沟通进一步帮助站点进行实施。

结论

在研究项目中开发的患者安全算法已在多个站点实施,以监测错过诊断机会的情况。自动算法翻译程序可以在站点之间产生更一致的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc5f/9289019/4b6c0efb1ccc/bmjhci-2022-100565f01.jpg

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