Development of electronic software for the management of trauma patients on the orthopaedic unit

Patel, Vipul; Raptis, D.A.; Christofi, T.; Mathew, Rajeev; Horwitz, Maxim D.; Eleftheriou, Kyriacos I.; McGovern, Paul D; Youngman, James; Patel, J. D.; Haddad, Fares S.

doi:10.1016/j.injury.2008.10.006

Cited by 12 publications

(27 citation statements)

References 19 publications

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“…[22][23][24][25][26][27]31,32 However, in 1 of these studies, 22.6% of respondents reported there was information they did not receive at handoff that would have helped them care for patients. 26 Other studies 22,25,30,33,36,37 noted that respondents reported increased quality of handoffs with an electronic handoff system. In 1 study, residents used 3 different handoff protocols (written, electronic, and face-to-face), with reports of protocol deviations lowest in the face-to-face phase (28%), highest with written handoffs (67%), and electronic handoffs falling in the middle (50%).…”

Section: Self-reported Measuresmentioning

confidence: 99%

“…In 1 study, residents used 3 different handoff protocols (written, electronic, and face-to-face), with reports of protocol deviations lowest in the face-to-face phase (28%), highest with written handoffs (67%), and electronic handoffs falling in the middle (50%). 38 In 9 studies (24%), perception of patient safety and/or quality of care improved 22,27,31,36,39 ; better patient management 21,25 or fewer near misses 30 were reported; and there was a reduction in missed patients. 34 However, a randomized crossover study found no statistically significant differences in resident-reported unexpected events, medical errors, or adverse drug events when comparing the electronic handoff system to the standard systems used (ie, written lists, card based, or a team-developed spreadsheet), 40 and another study found no difference in reported unexpected events pre-to postimplementation of a new electronic handoff system.…”

Section: Self-reported Measuresmentioning

confidence: 99%

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Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Davis¹,

Riesenberg²,

Mardis³

et al. 2015

Journal of Graduate Medical Education

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Background Multiple organizations have recognized that handoffs are prone to errors, and there has been an increase in the use of electronic health records and computerized tools in health care. Objective This systematic review evaluates the current evidence on the effectiveness of electronic solutions used to support shift-to-shift handoffs. Methods We searched the English-language literature for research studies published between January 1, 2008, and September 19, 2014, using National Library of Medicine PubMed, EBSCO CINAHL, OvidSP All Journals, and ProQuest PsycINFO. Included studies focused on the evaluation of physician shift-to-shift handoffs and an electronic solution designed to support handoffs. We assessed articles using a quality scoring system, conducted a review of barriers and strategies, and categorized study outcomes into self-report, process, and outcome measures. Results Thirty-seven articles met inclusion criteria, including 20 single group pre- and posttest studies; 8 posttest only or cross-sectional studies; 4 nonrandomized controlled trials; 1 cohort study; 1 randomized crossover study; and 3 qualitative studies. Quality scores ranged from 3.5 to 14 of a possible 16. Most articles documented some positive outcomes, with 2 of the 3 studies evaluating patient outcomes yielding statistically significant improvements. The only other study that analyzed patient outcomes showed that interventions other than the electronic tool were responsible for most of the significant improvements. Conclusions The majority of studies supported using an electronic tool, yet few measured patient outcomes, and numerous studies suffered from methodology issues. Future studies should evaluate patient outcomes, improve study design, assess the role of faculty oversight, and broaden the focus to recognize the role of human factors.

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Section: Self-reported Measuresmentioning

confidence: 99%

Section: Self-reported Measuresmentioning

confidence: 99%

Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Davis¹,

Riesenberg²,

Mardis³

et al. 2015

Journal of Graduate Medical Education

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“…The topics covered on our checklist include those used in previously developed checklists, including diagnosis, comorbidities, history, mechanism of injury and outstanding injuries. 5,[7][8][9]12 It is important to remember that our checklist is not exclusive; it contains a column for "other pertinent information" to address the variability among patients who present with traumatic injuries. The checklist provides a starting point for information that should not be missed, but as seen in Table 2, most of the information has been deemed important by a panel of orthopedic surgeons and trainees across the country and any can be added at the discretion of the admitting physician.…”

Section: Discussionmentioning

confidence: 99%

“…1 The risks to patient care associated with handover have been extensively studied among health care workers, including personnel from prehospital care, emergency department, nursing, intensive care unit (ICU), anesthesiology, general surgery, plastic surgery, neurosurgery and orthopedic surgery. [2][3][4][5][6][7][8][9][10][11][12] Many groups have proposed handover checklists as a manner to improve information retention and handover safety. [13][14][15][16][17] Medical errors are common, occurring in 3.2%-10.6% of patients, 18,19 and it is estimated that 58%-66% of these errors will result in patient injury.…”

mentioning

confidence: 99%

“…5,9 The British Medical Association (BMA) has advocated that every hospital should have their own handover policy and specify who should be involved, when handover should take place, where it should occur and what needs to be handed over. 1 Therefore, the purpose of the present study was to identify and survey Canadian Orthopaedic Association (COA) members about the vital clinical information needed for the development of a standardized, preoperative handover checklist for use with trauma patients.…”

mentioning

confidence: 99%

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Development of an orthopedic surgery trauma patient handover checklist

et al. 2014

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Development of an orthopedic surgery trauma patient handover checklistBackground: In surgery, preoperative handover of surgical trauma patients is a process that must be made as safe as possible. We sought to determine vital clinical information to be transferred between patient care teams and to develop a standardized handover checklist. Methods:We conducted standardized small-group interviews about trauma patient handover. Based on this information, we created a questionnaire to gather perspectives from all Canadian Orthopaedic Association (COA) members about which topics they felt would be most important on a handover checklist. We analyzed the responses to develop a standardized handover checklist. Results:Of the 1106 COA members, 247 responded to the questionnaire. The top 7 topics felt to be most important for achieving patient safety in the handover were comorbidities, diagnosis, readiness for the operating room, stability, associated injuries, history/mechanism of injury and outstanding issues. The expert recommendations were to have handover completed the same way every day, all appropriate radiographs available, adequate time, all appropriate laboratory work and more time to spend with patients with more severe illness. Conclusion:Our main recommendations for safe handover are to use standardized checklists specific to the patient and site needs. We provide an example of a standardized checklist that should be used for preoperative handovers. To our knowledge, this is the first checklist for handover developed by a group of experts in orthopedic surgery, which is both manageable in length and simple to use.Contexte : En chirurgie, le transfert préopératoire des polytraumatisés nécessi-tant une chirurgie est un processus que l'on doit rendre aussi sécuritaire que possible. Nous avons voulu déterminer quels renseignements cliniques vitaux doivent être transmis aux équipes de soins et préparer une liste de vérification standardisée à cette fin.Méthodes : Nous avons réalisé des entrevues standardisées par petits groupes au sujet du transfert des polytraumatisés. À partir des renseignements recueillis, nous avons élaboré un questionnaire pour obtenir le point de vue de tous les membres de l'Association canadienne d'orthopédie (ACO) au sujet des élé-ments jugés les plus importants sur une liste de vérification en vue du transfert. Nous avons analysé les réponses pour dresser une liste de vérification standardisée.Résultats : Sur les 1106 membres de l'ACO, 247 ont répondu au questionnaire. Les 7 éléments jugés les plus importants pour assurer la sécurité des patients lors du transfert ont été : comorbidités, diagnostic, état de préparation pour le bloc opéra-toire, stabilité, blessures connexes, histoire et mécanisme du traumatisme et questions en suspens. Les recommandations des experts ont été les suivantes : que les transferts s'effectuent de la même façon chaque jour, qu'on obtienne toutes les radiographies appropriées disponibles, qu'on dispose de temps suffisant, qu'on obtienne toute les analyses de lab...

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How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review

Flemming¹,

Hübner²

2013

International Journal of Medical Informatics

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Development of electronic software for the management of trauma patients on the orthopaedic unit

Cited by 12 publications

References 19 publications

Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Evaluating Outcomes of Electronic Tools Supporting Physician Shift-to-Shift Handoffs: A Systematic Review

Development of an orthopedic surgery trauma patient handover checklist

How to improve change of shift handovers and collaborative grounding and what role does the electronic patient record system play? Results of a systematic literature review

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