OBJECTIVES The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events. METHODS We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detec...

While nursing documentation in electronic medical record (EMR) flowsheets may represent the largest investment of clinician time with information systems, organizations lack tools to visualize and repurpose this data for research and quality improvement. Incorporating flowsheet documentation into a clinical data repository and methods to reduce the flowsheet ontology's redundancy are described....

BACKGROUND AND OBJECTIVE Inadequate follow-up of positive sexually transmitted infection (STI) test results is a gap in health care quality that contributes to the epidemic of STIs in adolescent women. The goal of this study was to improve our ability to contact adolescent women with positive STI test results after an emergency department visit. METHODS We conducted an interventional quality ...

Health care costs represent a significant percentage of a country’s GDP. Implementing electronic medical records (EMR) systems are a popular solution to reducing costs, with the side benefit of providing better care. Unfortunately, 30% of EMR system implementations fail, often because physicians cannot use the EMRs efficiently. User experience problems, based on our experience at several clinic...

conclusions considering that the most frequent reason for our urvs was patient-related factors, where all cases had left the cpu against medical advice (ama) during their first attendance, we recommend that further appropriate strategies be devised to prevent leaving against medical advice. results patient-related factors accounted for most 72 hours urvs (49%). multivariable analysis revealed t...

INTRODUCTION To determine emergency physician (EP) opinions of prehospital patient care reports (PCRs) and whether such reports are available at the time of emergency department (ED) medical decision-making. METHODS Prospective, cross-sectional, electronic web-based survey of EPs regarding preferences and availability of prehospital PCRs at the time of ED medical decision-making. RESULTS We...

BACKGROUND The identification of patients who pose an epidemic hazard when they are admitted to a health facility plays a role in preventing the risk of hospital acquired infection. An automated clinical decision support system to detect suspected cases, based on the principle of syndromic surveillance, is being developed at the University of Lyon's Hôpital de la Croix-Rousse. This tool will an...

BACKGROUND Diagnostic errors are the leading basis for malpractice claims in primary care, yet these errors are underidentified and understudied. Computerized methods used to screen for other types of errors (eg, medication related) have not been applied to diagnostic errors. Our objectives were to assess the feasibility of computerized screening to identify diagnostic errors in primary care an...

Firms’ decision-making is increasingly leaving an electronic trail. We ask how the threat of litigation affects decisions to adopt technologies that leave more of an electronic trail, like electronic medical records (EMR). On the one hand, firms may embrace a technology that allows them to easily document that their actions were appropriate if they have to defend them in court. On the other han...