The HELP hospital information system: update 1998

Gardner, Reed M.; Pryor, T. Allan; Warner, Homer R.

doi:10.1016/s1386-5056(99)00013-1

Cited by 120 publications

(77 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The O 2 values were adjusted for blood using methods previously described (45,46 Data for each hemodynamic parameter were tallied on a universal flow sheet and subsequently entered into a computerized database, with double checking for accuracy. The chamber T, HR, BP, RAP, and PAP values were continuously measured and stored every 5 min automatically by the HELP system at LDS Hospital (16,17).…”

Section: Methodsmentioning

confidence: 99%

Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen

Weaver¹,

Howe²,

Snow³

et al. 2009

Journal of Applied Physiology

View full text Add to dashboard Cite

Weaver LK, Howe S, Snow GL, Deru K. Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen. J Appl Physiol 107: 336-345, 2009. First published April 30, 2009 doi:10.1152/japplphysiol.91012.2008.-Divers and hyperbaric chamber attendants breathe hyperbaric air routinely. Hyperbaric oxygen (HBO2) is used therapeutically frequently. Although much is understood about the hemodynamic physiology and gas exchange effects during hyperbaric air and HBO2 exposure, arterial and pulmonary arterial (PA) catheter data, including blood gas values during hyperbaric air and HBO2 exposure of normal humans, have not been reported. We exposed 10 healthy volunteers instrumented with arterial and PA catheters to air at 0.85, 3.0, 2.5, 2.0, 1.3 (decompression stop), 1.12 (decompression stop), and 0.85 atm abs (our altitude) and then at identical pressures breathing O2 followed by atmospheric pressure air while we measured arterial and PA pressures (PAP), cardiac output (Q ), and blood gas measurements from both arterial and PA catheters. Although hemodynamic changes occurred during exposure to both hyperbaric air and HBO2, we observed a greater magnitude of change under HBO2 conditions: heart rate changes ranged from Ϫ9 to Ϫ19% (air to O2), respiratory rate from Ϫ12 to Ϫ17%, Q from Ϫ7 to Ϫ18%, PAP from Ϫ18 to Ϫ19%, pulmonary vascular resistance from Ϫ38 to Ϫ48%, and right-to-left shunt fraction from Ϫ87 to Ϫ107%. Mixed venous CO2 fell 8% from baseline during HBO2 despite mixed venous O2 tensions of several hundred Torr. The stroke volume, O2 delivery, and O2 consumption did not change across exposures. The arterial and mixed venous partial pressures of O2 and contents were elevated, as predicted. O2 extraction increased 37% during HBO2. hyperbaric oxygen; pulmonary arterial catheter; cardiac output; oxygen extraction THOUSANDS OF PATIENTS have been treated with hyperbaric oxygen (HBO 2 ); however, the precise arterial and pulmonary arterial (PA) hemodynamic and gas exchange responses that occur during HBO 2 are not clearly known. Determining precise hemodynamic and gas exchange information requires the subject or patient to be instrumented with arterial and PA (SwanGanz) catheters, permitting measurement of intravascular pressures and blood gases, and PA catheter data collected in normal humans exposed to HBO 2 has been reported only once (24).It has long been established that heart rate (HR) falls during HBO 2 (3). Forty years ago, investigators reported that this reduction in HR was associated with decreased cardiac output (Q ) (48), an observation supported by subsequent research (Table 1) (21,24,27,29,48). Generally accepted hemodynamic effects of HBO 2 now "include mild bradycardia, leading to a proportional decline in Q and a small increase in systemic vascular resistance" (28).As (43), possibly due to high O 2 concentrations reducing myocardial relaxation factor (nitric oxide), thereby making the heart stiffer (23), or by an increase in afterload from i...

show abstract

Section: Methodsmentioning

confidence: 99%

Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen

Weaver¹,

Howe²,

Snow³

et al. 2009

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

“…19 HELP is a fully integrated hospital information system that provides data collection and reporting for a broad range of clinical arenas, including laboratory results, pharmacy, radiology, and pathology. The PICU physicians and nurse practitioners use the HELP system primarily for laboratory results review and the generation of a morning summary report of patient vital signs, labs, pharmacology, radiology, and ventilator data.…”

Section: Settingmentioning

confidence: 99%

Development and Impact of a Computerized Pediatric Antiinfective Decision Support Program

et al. 2001

View full text Add to dashboard Cite

ABSTRACT. Objective. Computerized medical decision support tools have been shown to improve the quality of care and have been cited by the Institute of Medicine as one method to reduce pharmaceutical errors. We evaluated the impact of an antiinfective decision support tool in a pediatric intensive care unit (PICU).Methods. We enhanced an existing adult antiinfective management tool by adding and changing medical logic to make it appropriate for pediatric patients. Process and outcomes measures were monitored prospectively during a 6-month control and a 6-month intervention period. Mandatory use of the decision support tool was initiated for all antiinfective orders in a 26-bed PICU during the intervention period. Clinician opinions of the decision support tool were surveyed via questionnaire.Results. The rate of pharmacy interventions for erroneous drug doses declined by 59%. The rate of antiinfective subtherapeutic patient days decreased by 36%, and the rate of excessive-dose days declined by 28%. The number of orders placed per antiinfective course decreased 11.5%, and the robust estimate of the antiinfective costs per patient decreased 9%. The type of antiinfectives ordered and the number of antiinfective doses per patient remained similar, as did the rates of adverse drug events and antibiotic-bacterial susceptibility mismatches. The surveyed clinicians reported that use of the program improved their antiinfective agent choices as well as their awareness of impairments in renal function and reduced the likelihood of adverse drug events.Conclusions. Use of the pediatric antiinfective decision support tool in a PICU was considered beneficial to patient care by the clinicians and reduced the rates of erroneous drug orders, improved therapeutic dosage targets, and was associated with a decreased robust estimate of antiinfective costs per patient. Pediatrics 2001;108(4). URL: http://www.pediatrics.org/cgi/content/full/108/4/ e75; antiinfective agents, decision support systems, drug therapy, medication errors, child, infant.

show abstract

“…The ED staff uses an integrated clinical information system (HELP System) that supports clinicians in documenting, reporting, and making clinical decisions providing a variety of computerized decision support systems. 26 A version of the clinical information system specifically designed for the ED was installed in June 1995.…”

Section: Methodsmentioning

confidence: 99%

A Comprehensive Set of Coded Chief Complaints for the Emergency Department

Aronsky

Kendall

Merkley

et al. 2001

Academic Emergency Medicine

View full text Add to dashboard Cite

Abstract. Objective: To develop a generally applicable set of coded chief complaints for the computerized patient records of emergency departments (EDs). Methods: At an urban teaching ED the chief complaints of more than 50,000 patients were analyzed retrospectively during a 29-month period (June 1995-October 1997. Applying continuous quality improvement methods, a multidisciplinary team examined the current process documenting the patient's chief complaint. During two prospective periods (November 1997-December 1998 January 1999-June 1999, more than 34,000 chief complaints were analyzed. To reduce free-text charting practices, a variety of interventions on individual and team level were applied. Quantitative analysis was performed with statistical process control charts, and a qualitative evaluation was performed with a questionnaire. Results: The charting of chief complaint in free-text format decreased from 23% to 1%. The range among individual ED staff members narrowed from 45% to 9%.During the refinement of the set of coded chief complaints, six infrequently charted items were removed. Five new chief complaints identified by analysis of free-text entries during the second study period were added. The current set of chief complaints consists of 54 codable and the three original free-text items. The ED staff members perceived all the interventions beneficial. A poster displaying all available terms as a visual aid, however, had the largest impact on charting the patient's chief complaint in coded format. Conclusions: Applying continuous quality improvement methods, the authors created a clinically developed and applicable set of codable chief complaints that can be easily integrated into a computerized patient record of an ED. puterized decision support system for estimating the probability of acute myocardial infarction. 5These clinical, research, and administrative objectives all rely on the presence of an easily identifiable, unambiguous, and coded chief complaint. The chief complaint is routinely and often repeatedly collected during a patient's encounter and represents a central piece of information that directs care. It is the ''patient's reason for seeking care or attention, expressed in terms as close as possible to those used by patient or responsible informant. '' 6 Many emergency departments (EDs) consider moving from a paper-based to a computerized patient record. The computerized patient record represents a rich data source that has the potential to support clinicians in providing care efficiently, cost-effectively, and at the point of care.7-9 However, to take advantage of the capabilities of a clinical information system in the ED, standards for recording ED information and coded data entry are highly desirable.10,11 Continuing the tradition of documenting patient care in free-text format pre-

show abstract

The HELP hospital information system: update 1998

Cited by 120 publications

References 19 publications

Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen

Arterial and pulmonary arterial hemodynamics and oxygen delivery/extraction in normal humans exposed to hyperbaric air and oxygen

Development and Impact of a Computerized Pediatric Antiinfective Decision Support Program

A Comprehensive Set of Coded Chief Complaints for the Emergency Department

Contact Info

Product

Resources

About