Medicine and Health Sciences Commons^™

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Journal Articles

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

Home Blood Pressure Telemonitoring Technology For Patients With Asymptomatic Elevated Blood Pressure Discharged From The Emergency Department: Pilot Study, Karen C Tran, Meagan Mak, Laura M Kuyper, Jesse Bittman, Birinder Mangat, Heather Lindsay, Chad Kim Sing, Liang Xu, Hubert Wong, Martin Dawes, Nadia Khan, Kendall Ho

Journal Articles

BACKGROUND: Hypertension affects 1 in 5 Canadians and is the leading cause of morbidity and mortality globally. Hypertension control is declining due to multiple factors including lack of access to primary care. Consequently, patients with hypertension frequently visit the emergency department (ED) due to high blood pressure (BP). Telehealth for Emergency-Community Continuity of Care Connectivity via Home-Telemonitoring Blood Pressure is a pilot project that implements and evaluates a comprehensive home blood pressure telemonitoring (HBPT) and physician case management protocol designed as a postdischarge management strategy to support patients with asymptomatic elevated BP as they transition from the ED to home. …

Usability And Technology Acceptance Of An Electronic Child Abuse Screening Tool In A Pediatric Emergency Department, Angela Hayes

Translational Projects (Open Access)

Up to half of all child physical abuse victims with major abuse injuries seen in hospitals had sentinel injuries assessed by medical providers. Universal screening for child abuse and neglect in the emergency department can potentially increase detection at lower levels of injury. However, we must consider usability for the electronic health record embedded child abuse and neglect-screening tool to be most effective. The user most likely to interact with the screening tool is the bedside nurse. The interface of the initial screening tool and the process of inputting information must be perceived as useful, usable, and satisfying to the …

Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, Megan Tuetken, Sierra Hamlin, Sydney Spaulding

Doctor of Nursing Practice Projects

Nationwide, the volume of emergency department (ED) visits has steadily increased over the last several decades. This steady increase in volume frequently causes ED crowding and considerable delays in patient evaluation and treatment. Recently, teletriage has been used in emergency departments to evaluate less emergent patient needs while freeing up in-house providers to care for more critical patients. The goal of this DNP project was to develop a protocol for the utilization of teletriage in an Emergency Department in a level 1 trauma center in central Illinois using nurse practitioners to assess patients in the waiting room and order appropriate …

Evaluating The Impact Of Kardiamobile On Healthcare Expenditures, Christopher Gerace, Mph, Daniel Frisch, Md

Phase 1

Background: KardiaMobile is a mobile ECG device, with smartphone connectivity, that is able to detect atrial fibrillation (a-fib). The device captures a 30 second reading and an algorithm differentiates a-fib from sinus rhythm. The mobile application can alert the user to an a-fib reading and also send the ECG output to their personal physician. By monitoring a-fib without accessing traditional care, KardiaMobile has the potential to reduce healthcare costs for patients with a-fib. This study looked to evaluate the effect of KardiaMobile on healthcare utilization for patients with suspected or diagnosed a-fib and who see a clinical cardiac electrophysiologist.

Methods: …

Registered Nurses’ Perceptions Of The Electronic Canadian Triage And Acuity Scale In A Community Hospital, Andrea De Jong

Electronic Thesis and Dissertation Repository

In 2017, several hospitals in Ontario implemented the Electronic Canadian Triage and Acuity Scale (eCTAS). This new technology affects a critical area of the Emergency Department: triage. There is no research on Registered Nurses’ (RNs) perceptions of eCTAS. A quantitative non-experimental descriptive survey obtained and quantified RN perceptions of eCTAS at a hospital with a 23 bed Emergency Department. The Diffusion of Innovation Theory was used as the theoretical framework to help guide study development. Results indicate both positive and negative perceptions of eCTAS and that younger RNs are more likely to think eCTAS cues them to collect the relevant …

Implementation Of A ‘Flow’ Attending Reduces Overall Ed Length Of Stay In Telehealth Intake Model, R. Fuega, K. Maloney, R. A. Band, B. H. Slovis, K. S. London, J. L. White

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

In an effort to improve our efficiency, the Department of Emergency Medicine recently transitioned from an in person physician triage model to a telehealth intake model. With this change, many new gaps have been identified. By uncoupling triage from the in person intake provider, we lost the ability to manage “quick” discharges, to provide secondary oversight of the patients in the internal waiting room, and to directly supervise patients seen in the fast track area. In order to address these new concerns, and to mitigate the loss felt by removing the in person provider from intake, a ‘flow’ attending …

The Nationwide Health Information Network: The Case Of The Expansion Of Health Information Exchanges In The United States, Morgan Ruley, Victoria Walker, Jana Studeny, Alberto Coustasse

Management Faculty Research

The Nationwide Health Information Network (NHIN) implemented secure exchange of health records through utilization of the Internet. NHIN has greatly assisted in achieving the goals of the HITECH Act by promoting the adoption of Meaningful Use. Epic introduced a Health Information Exchange (HIE) platform, Care Everywhere (CE), which has facilitated HIE availability. The purpose of this research was to determine the impact of NHIN and Epic Care’s CE on healthcare to determine whether their use in the ED has increased. The methodology for this study utilized a literature review. Twenty-nine sources were referenced for this study. With the NHIN implementation, …

Decreasing Time To Broad Spectrum Antibiotics For Septic Patients In The Emergency Department, Joseph J. Zieminski, Emily E. Bryant

Journal of Patient-Centered Research and Reviews

Background: Timely administration of broad spectrum antibiotics has been shown to be directly correlated with decreased mortality for patients with severe sepsis and septic shock. As such, both the Surviving Sepsis Campaign and the SEP-1 CMS measure recognize timely antibiotic administration as a cornerstone of therapy for patients with severe sepsis or septic shock.

Purpose: Decrease time to broad spectrum antibiotic administration for septic patients in the emergency department (ED) of Aurora St. Luke’s Medical Center.

Methods: An alert within the electronic medical record was created to more rapidly identify potentially septic patients in the ED. After receiving the alert, …