Integrating feedback from a clinical data warehouse into practice organisation

Grant, Andrew; Moshyk, Andriy; Diab, Hassan Mahmoud; Caron, Philippe; Lorenzi, Fabien de; Bisson, Guy; Menard, Line; Lefebvre, R. Craig; Gauthier, Patricia; Grondin, Richard; Désautels, M. C.

doi:10.1016/j.ijmedinf.2005.07.037

Cited by 35 publications

(24 citation statements)

References 4 publications

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“…This single operational database includes all transactions of admission, diagnostics, therapeutics, and interventions. 16 The CI-RESSS research-purpose data warehouse of the CHUS is linked to the ARIANE system and updated every 24 hr. The database also incorporates MEDECHO data (Système de maintenance et d'exploitation des données pour l'étude de la clientèle hospitalière) required by the Quebec Ministry of Health.…”

Section: Methodsmentioning

confidence: 99%

“…The data collected include demographics, detailed information on all primary and secondary diagnoses using International Classification of Diseases ninth revision (ICD-9) codes before 2006 and tenth revision ICD-10 codes after 2006, procedures using Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures before 2006 and the Canadian Classification of Health Interventions after 2006, and biochemical and clinical data. 16 This database includes data on all admissions at the main site (Fleurimont) since 1997. Data from a second (Hotel-Dieu) site have been collected since 2001.…”

Section: Methodsmentioning

confidence: 99%

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Thrombocytopenia in the critically ill: prevalence, incidence, risk factors, and clinical outcomes

Williamson

Lesur

Tétrault

et al. 2013

Can J Anesth/J Can Anesth

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Purpose The aim of this cohort study was to describe the prevalence, incidence, and risk factors for thrombocytopenia in the intensive care unit (ICU) and to evaluate the impact of thrombocytopenia on mortality with further comparisons amongst major diagnostic categories. Methods Patients admitted to the ICU from 1997-2011 for cardiac, medical, surgical, and trauma conditions were included. The presence of a platelet count\ 100 9 10 9 ÁL -1 on admission day or its appearance during ICU stay were considered as prevalent and incident thrombocytopenia, respectively. Risk factors for thrombocytopenia and the influence of thrombocytopenia on mortality were also analyzed. Results This study included 20,696 patients. Prevalent and incident thrombocytopenia occurred in 13.3% and 7.8% of patients, respectively, with associated mortality rates of 14.3% and 24.7%, respectively, compared with 10.2% in the group with normal platelet count (P \ 0.001). After adjustments, thrombocytopenia remained associated with an increased risk of mortality (odds ratio 1.25; 95% confidence interval 1.20 to 1.31; P \ 0.001). The greatest impact of thrombocytopenia on mortality was observed in the cancer, respiratory, digestive, genitourinary, and infectious diagnostic categories. Independent risk factors included age, female sex, admission platelet counts and hemoglobin, mechanical ventilation, days of hospitalization prior to ICU admission, liver cirrhosis, hypersplenism, coronary bypass grafting, intra-aortic balloon pump placement, acute hepatitis, septic shock, and pulmonary embolism or deep vein thrombosis. Conclusions Thrombocytopenia in the ICU is associated with an independent risk of mortality that varies greatly depending on diagnostic admission category.Electronic supplementary material The online version of this article

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Thrombocytopenia in the critically ill: prevalence, incidence, risk factors, and clinical outcomes

Williamson

Lesur

Tétrault

et al. 2013

Can J Anesth/J Can Anesth

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“…In addition to directly impacting clinical process, secondary EHR data can be used for quality assurance (Einbinder, Scully, Pates, Schubart, & Reynolds, 2001) and performance improvement (Grant et al, 2006). However, there are few publications about integration of feedback from secondary data into the clinical team's practice (Neil & Nerenz, 2003).…”

Section: Downloaded By [Erciyes University] At 16:39 22 December 2014mentioning

confidence: 99%

Challenges and Facilitators to Adoption of a Point-of-Care Electronic Health Record in Home Care

Sockolow

Bowles

Adelsberger

et al. 2014

Home Health Care Services Quarterly

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Electronic health records (EHRs), intended to improve the clinical process, are understudied in home care. The researchers assessed clinician satisfaction, informed by workflow and patient outcomes, to identify EHR adoption challenges. The mixed methods study setting was a Philadelphia agency with 137 clinicians. Adoption challenges included: (a) hardware problems coupled with lack of field support; (b) inadequate training; and (c) mismatch of EHR usability/functionality and workflow resulting in decreased efficiency. Adoption facilitators were support for team communication and improved clinical data timeliness. Opportunities for improved adoption included sharing with front-line clinicians EHR data related to patient care and health outcomes.

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“…The first was the research-purpose database 9 of the Centre informatisé de recherche évaluative en services et soins de santé of the Centre hospitalier universitaire de Sherbrooke, a tertiary care teaching hospital in the province of Quebec. Along with demographic data, this database included, for each hospital admission since 1996, detailed information on all primary and secondary diagnoses, coded according to the International Classification of Diseases, 9th revision (ICD-9).…”

Section: Data Sourcesmentioning

confidence: 99%

Pneumococcal vaccination and risk of myocardial infarction

Lamontagne¹,

Garant²,

Carvalho³

et al. 2008

Canadian Medical Association Journal

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D espite important advances in primary prevention, atherosclerosis remains the leading cause of death in developed societies.1 In addition to risk factors such as hypertension, diabetes mellitus, tobacco use and dyslipidemia, less traditional risk factors have also been sought. Many markers, including C-reactive protein and interleukins, highlight inflammation as a key mediator in both the progression and activation of atherosclerotic lesions.2-4 Some medications that are used to prevent cardiovascular diseases, such as statins, also appear to reduce inflammation. 5 Animal experiments have shown that pneumococcal vaccination reduces the extent of atherosclerotic lesions. 6 We hypothesized that antibodies directed against Streptococcus pneumoniae also recognize oxidized low-density lipoprotein (LDL) and impede the formation of foam cells. Interestingly, a retrospective cohort study involving World War II veterans who had undergone splenectomy documented excess mortality rates from both pneumonia and ischemic heart disease. 7 More recent data have suggested that acute pneumococcal infections, but not vaccinations, increase the risk of vascular events; 8 however, the duration of vaccination exposure considered in that study was limited.Our primary objective was to evaluate the association between pneumococcal vaccination and the risk of myocardial infarction. We also explored whether any effect of vaccination on the risk of infarction waned over time. Methods Design and ethics approvalWe conducted a case-control study of patients who were considered at risk for myocardial infarction and who had been admitted to a tertiary care hospital. We obtained approval for this study from the research ethics board of the Centre hospitalier universitaire de Sherbrooke and Quebec's Commission d'accès à l'information. Data sourcesWe used 2 databases for this study. The first was the research-purpose database 9 of the Centre informatisé de recherche évaluative en services et soins de santé of the Centre hospitalier universitaire de Sherbrooke, a tertiary care teaching hospital in the province of Quebec. Along with demographic data, this database included, for each hospital admission since 1996, detailed information on all primary and secondary diagnoses, coded according to the International Classification of Diseases, 9th revision (ICD-9). This database also contained all biochemical and pharmaceutical data recorded during the admission, including, for each medication prescribed, the name, dosage, formulation, quantity dis- Pneumococcal vaccination and risk of myocardial infarctionFrom the Department of Medicine (Lamontagne, Garant, Carvalho, Lanthier, Pilon), Université de Sherbrooke, Sherbrooke, Que.; and the Department of Clinical Epidemiology and Biostatistics (Lamontagne, Smieja), McMaster University, Hamilton, Ont. CMAJ ResearchBackground: Based on promising results from laboratory studies, we hypothesized that pneumococcal vaccination would protect patients from myocardial infarction. Methods:We conducted a hospital-based ...

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Integrating feedback from a clinical data warehouse into practice organisation

Cited by 35 publications

References 4 publications

Thrombocytopenia in the critically ill: prevalence, incidence, risk factors, and clinical outcomes

Thrombocytopenia in the critically ill: prevalence, incidence, risk factors, and clinical outcomes

Challenges and Facilitators to Adoption of a Point-of-Care Electronic Health Record in Home Care

Pneumococcal vaccination and risk of myocardial infarction

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