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The efficiency and effectiveness of surgery information systems in Iran.

ABSTRACT: BACKGROUND:Despite the prevalent use and advantages of information systems in hospitals, some have failed to meet their predefined objectives. Surgery information system (SIS) is a sub-system of a hospital information system. Its effective and efficient operation could enhance patient care in the busy environment of operating rooms with multiple tasks. The objective of this study was to evaluate the effectiveness and efficiency of SIS in three educational hospitals. METHODS:Data were collected using a questionnaire completed by 82 users of SIS. This questionnaire contains three parts: 1) participants' demographic information, 2) questions regarding the efficiency of SIS, and 3) questions about its effectiveness. An independent sample t-test was used to compare the efficiency and effectiveness among systems. Chi-squared and Fisher tests were used to determine the relationship between the participants' demographics and efficiency and effectiveness as well as the relationship between efficiency and effectiveness. RESULTS:About 23% of the participants rated the system's efficiency as low, 29% as medium, and 48% as high. Besides, 24% of the participants considered the effectiveness of the system as low, 31% as medium, and 45% as high. There was a significant correlation between the efficiency and effectiveness of SIS (p???0.0001). CONCLUSION:Based on the perspective of most participants (44%)the efficiency and effectiveness of both surgery information systems were acceptable. The results suggest that these systems should be designed in a way that facilitate user's interaction and reduce the time takes to complete tasks. The results could be useful for developing and designing an efficient and effective system.

SUBMITTER: Abbasi F

PROVIDER: S-EPMC7493378 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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The efficiency and effectiveness of surgery information systems in Iran.

Abbasi Faezeh F Khajouei Reza R Mirzaee Moghaddameh M

BMC medical informatics and decision making 20200916 1

<h4>Background</h4>Despite the prevalent use and advantages of information systems in hospitals, some have failed to meet their predefined objectives. Surgery information system (SIS) is a sub-system of a hospital information system. Its effective and efficient operation could enhance patient care in the busy environment of operating rooms with multiple tasks. The objective of this study was to evaluate the effectiveness and efficiency of SIS in three educational hospitals.<h4>Methods</h4>Data w ...[more]

PMID: 32938452

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Project description:BackgroundClinical alarm system safety is a national patient safety goal in the United States. Physiologic monitors are associated with the highest number of device alarms and alarm-related deaths. However, research involving nurses' use of physiologic monitors is rare. Hence, the identification of critical usability issues for monitors, especially those related to patient safety, is a nursing imperative.ObjectiveThis study examined nurses' usability of physiologic monitors in intensive care units with respect to the effectiveness and efficiency of monitor use.MethodsIn total, 30 nurses from 4 adult intensive care units completed 40 tasks in a simulation environment. The tasks were common monitoring tasks that were crucial for appropriate monitoring and safe alarm management across four categories of competencies: admitting, transferring, and discharging patients using the monitors (7 tasks); managing measurements and monitor settings (23 tasks); performing electrocardiogram (ECG) analysis (7 tasks); and troubleshooting alarm conditions (3 tasks). The nurse-monitor interaction was video-recorded. The principal investigator and two expert intensive care units nurse educators identified, classified, and validated task success (effectiveness) and the time of task completion (efficiency).ResultsAmong the 40 tasks, only 2 (5%) were successfully completed by all the nurses. At least 1-27 (3%-90%) nurses abandoned or did not correctly perform 38 tasks. The task with the shortest completion time was "take monitor out of standby" (mean 0:02, SD 0:01 min:s), whereas the task "record a 25 mm/s ECG strip of any of the ECG leads" had the longest completion time (mean 1:14, SD 0:32 min:s). The total time to complete 37 navigation-related tasks ranged from a minimum of 3 min 57 s to a maximum of 32 min 42 s. Regression analysis showed that it took 6 s per click or step to successfully complete a task. To understand the nurses' thought processes during monitor navigation, the authors analyzed the paths of the 2 tasks with the lowest successful completion rates, where only 13% (4/30) of the nurses correctly completed these 2 tasks. Although 30% (9/30) of the nurses accessed the correct screen first for task 1 and task 2, they could not find their way easily from there to successfully complete the 2 tasks.ConclusionsUsability testing of physiologic monitors revealed major ineffectiveness and inefficiencies in the current nurse-monitor interactions. The results indicate the potential for safety and productivity issues in completing routine tasks. Training on monitor use should include critical monitoring functions that are necessary for safe, effective, efficient, and appropriate monitoring to include knowledge of the shortest navigation path. It is imperative that vendors' future monitor designs mimic clinicians' thought processes for successful, safe, and efficient monitor navigation.

Project description:BackgroundThis protocol concerns the assessment of cost-effectiveness of hospital health information technology (HIT) in four hospitals. Two of these hospitals are acquiring ePrescribing systems incorporating extensive decision support, while the other two will implement systems incorporating more basic clinical algorithms. Implementation of an ePrescribing system will have diffuse effects over myriad clinical processes, so the protocol has to deal with a large amount of information collected at various 'levels' across the system.Methods/designThe method we propose is use of Bayesian ideas as a philosophical guide.Assessment of cost-effectiveness requires a number of parameters in order to measure incremental cost utility or benefit - the effectiveness of the intervention in reducing frequency of preventable adverse events; utilities for these adverse events; costs of HIT systems; and cost consequences of adverse events averted. There is no single end-point that adequately and unproblematically captures the effectiveness of the intervention; we therefore plan to observe changes in error rates and adverse events in four error categories (death, permanent disability, moderate disability, minimal effect). For each category we will elicit and pool subjective probability densities from experts for reductions in adverse events, resulting from deployment of the intervention in a hospital with extensive decision support. The experts will have been briefed with quantitative and qualitative data from the study and external data sources prior to elicitation. Following this, there will be a process of deliberative dialogues so that experts can "re-calibrate" their subjective probability estimates. The consolidated densities assembled from the repeat elicitation exercise will then be used to populate a health economic model, along with salient utilities. The credible limits from these densities can define thresholds for sensitivity analyses.DiscussionThe protocol we present here was designed for evaluation of ePrescribing systems. However, the methodology we propose could be used whenever research cannot provide a direct and unbiased measure of comparative effectiveness.

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The efficiency and effectiveness of surgery information systems in Iran.

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The efficiency and effectiveness of surgery information systems in Iran.

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