Advanced Nurse-Patient Communication System

Effective communication is the most important part of any healthcare organization. For many years, hospital nurse call solutions had been stand-alone systems with occasional integration to pocket paging for outputting patient call alerts to mobile staff. In the late 1990’s, technology enabled in-building wireless phones to supplement or replace paging systems as a means of not only sending alerts, but also enabling voice communication between mobile staff and patients. Today’s nurse call market requires integration of additional information from location and ADT (admit, discharge, transfer) systems into what have traditionally been nurse call applications. This system information is required not only at the nursing station, pagers, and phones, but also at PC’s placed on each patient care floor in hallways, nurse stations, and offices, and at areas away from the patients, including administrator and clinical engineering offices. It is crucial that nurses have the latest patient information in their hand wherever they go in the hospital. In this paper, MatchMaker.NET has been developed to integrate all these technologies into the hospital’s LAN to improve nurse-patient communication.     

Use of SMS text messaging to improve outpatient attendance

OBJECTIVE: To evaluate the effect of appointment reminders sent as short message service (SMS) text messages to patients' mobile telephones on attendance at outpatient clinics. DESIGN: Cohort study with historical control. SETTING: Royal Children's Hospital, Melbourne, Victoria. PATIENTS: Patients who gave a mobile telephone contact number and were scheduled to attend any of five outpatient clinics (dermatology, gastroenterology, general medicine, paediatric dentistry and plastic surgery) in September (trial group) or August (control group), 2004. MAIN OUTCOME MEASURES: Failure to attend (FTA) rate compared between the group sent a reminder and those who were not. RESULTS: 2151 patients were scheduled to attend a clinic in September; 1382 of these (64.2%) gave a mobile telephone contact number and were sent an SMS reminder (trial group). Corresponding numbers in the control group were 2276 scheduled to attend and 1482 (65.1%) who gave a mobile telephone number. The FTA rate for individual clinics was 12%-16% for the trial group, and 19%-39% for the control group. Overall FTA rate was significantly lower in the trial group than in the control group (14.2% v 23.4%; P < 0.001). CONCLUSIONS: The observed reduction in failure to attend rate was in line with that found using traditional reminder methods. The ease with which large numbers of messages can be customised and sent by SMS text messaging, along with its availability and comparatively low cost, suggest it may be a suitable means of improving patient attendance.     

Association Between TG-to-HDL-C Ratio and In-Stent Stenosis Under Optical Coherence Tomography Guidance

Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service. We conducted a prospective, observational, survey-based study over twenty-four weeks in an academic tertiary care center with attending physicians and residents. Our intervention involved the implementation of an HFCD alongside the existing paging system. Fifty-six pre and post surveys evaluated the perception of improvement in communication and the integration of the HFCD into existing workflow. We saw significant improvements in the ability of an HFCD to help physicians communicate thoughts clearly, communicate thoughts effectively, reach team members, reach ancillary staff, and stay informed about patients. Physicians also reported better workflow integration during admissions, rounds, discharge, and teaching sessions. Qualitative data from post surveys demonstrated that the greatest strengths of the HFCD included the ability to reach colleagues and staff quickly, provide instant access to individuals of the care team, and improve overall communication. Integration of an instantaneous, hands free, closed loop communication system alongside the existing pager system can provide improvements in the perceptions of communication and workflow integration in an academic medicine service. Future studies are needed to correlate these subjective findings with objective measures of quality and safety.     

借助医院网络信息系统提升图书馆信息服务水平

在分析医院图书馆信息服务现状的基础上,介绍解放军第451医院图书馆借助医院网络信息系统提升信息服务水平的措施,包括系统整合一站式服务、图书馆自动化管理、医学信息报道、公共信息服务、即时信息服务、信息流通与互动、文献传递服务等方面。     

Initial Experience with Patient-Clinician Secure Messaging at a VA Medical Center

The authors implemented what is possibly the first secure messaging system in a VA Medical Center. Since reimbursement for secure messaging is not of great concern and clinical data systems are fully computerized, several evaluation strategies were used to assess clinical adoption. To address known concerns of clinicians, the authors analyzed secure messaging use and performed a content analysis. Message volumes were low and content analysis demonstrated that messages were appropriate. Despite this, a clinician survey showed that clinical adoption was impeded by several factors including the introduction of secure messaging to selected patients, workload concerns, and clinician communication preferences. In addition, the authors believe that clinicians experienced clinical adoption inertia resulting from the overload of information in a highly computerized clinical environment. The authors learned that to promote clinician adoption they must demonstrate workload benefits from secure messaging and more fully analyze the clinical computing workload that clinicians experience.     

医院门诊智能寻呼排队系统的构建

为营造公平、合理、有效的门诊就诊环境，建立精确候诊就医通道，通过中国移动集团寻呼功能，结合医院信息系统（HIS），建立了医院门诊智能寻呼排队系统。该系统利用就诊业务流程实现了医院门诊管理的实时、快捷和通畅，提高了服务效率，提升了医院良好的窗口服务形象。     

基于ASP.NET的网络传真系统设计与实现

目的通过ASP.NET和MS SQL2000构建的网络平台实现电子传真功能。方法以ASP.NET和MSSQL2000系统为平台开发网络传真系统的的上层软件的网络服务界面,将文件通过网络界面上传,上层软件接收到文件后将数据转换并通过电话交换网发送到普通传真机上。结果使用ASP.NET和MS SQL2000构成的网络平台可以实现电子传真功能。结论网络传真具有安全、方便、快捷、经济的特点,本系统的实现具有很高的实用价值。     

医院分时就诊服务流程优化设计

针对患者预约服务及候诊排队拥挤的问题,讨论了基于手机短信的院外候诊服务流程和基于专家问诊时间的分时就诊流程。首先介绍了预约诊疗的几种模式,并讨论了预约就诊数据交换流程,然后阐述了基于手机短信的院外候诊服务流程和基于专家问诊时间的分时就诊流程,完全改变了传统取号后直接候诊的就医流程。主要从院外候诊、分时就诊以及服务质量评价几个方面对预约诊疗服务流程进行优化,对有效解决医院“三长一短”问题,缓解医院拥挤的现状,减少患者感染几率具有非常重要作用。     

医院病房监控系统设计与开发

结合成都医学院第一附属医院实际,根据物联网技术设计医院病房监控系统,介绍该系统的总体设计、网络通讯开发、GPRS短信服务、数据库设计及运行情况,该系统的使用使得患者与医护人员之间的联系更为紧密,尽而提高医院的服务质量。     

Evaluating the reliability, validity, acceptability, and practicality of SMS text messaging as a tool to collect research data: results from the Feeding Your Baby project

Objective

To test the reliability, validity, acceptability, and practicality of short message service (SMS) messaging for collection of research data.

Materials and methods

The studies were carried out in a cohort of recently delivered women in Tayside, Scotland, UK, who were asked about their current infant feeding method and future feeding plans. Reliability was assessed by comparison of their responses to two SMS messages sent 1 day apart. Validity was assessed by comparison of their responses to text questions and the same question administered by phone 1 day later, by comparison with the same data collected from other sources, and by correlation with other related measures. Acceptability was evaluated using quantitative and qualitative questions, and practicality by analysis of a researcher log.

Results

Reliability of the factual SMS message gave perfect agreement. Reliabilities for the numerical question were reasonable, with κ between 0.76 (95% CI 0.56 to 0.96) and 0.80 (95% CI 0.59 to 1.00). Validity for data compared with that collected by phone within 24 h (κ =0.92 (95% CI 0.84 to 1.00)) and with health visitor data (κ =0.85 (95% CI 0.73 to 0.97)) was excellent. Correlation validity between the text responses and other related demographic and clinical measures was as expected. Participants found the method a convenient and acceptable way of providing data. For researchers, SMS text messaging provided an easy and functional method of gathering a large volume of data.

Conclusion

In this sample and for these questions, SMS was a reliable and valid method for capturing research data.     

An Innovative Approach to Improve Communication and Reduce Physician Stress and Burnout in a University Affiliated Residency Program

Ineffective communication between nursing staff and residents leads to numerous educational and patient-care interruptions, increasing resident stress and overall workload. We developed an innovative and simple, secure electronic health record (EHR) base text paging system to communicate with internal medicine residents. The goal is to avoid unnecessary interruption during patient care or educational activities and reduce stress. Traditional paging system can send a phone number to call back. We developed and implemented a HIPPA-compliant, EHR-integrated text paging at a busy 591-bed urban hospital. Access was granted to unit clerks, nursing staff, case managers, and physicians. Senders could either send a traditional telephone number page or a text page through our EHR. The recipient could then either acknowledge receipt of the page or take appropriate actions. Afterward, Internal medicine residents were polled on overall satisfaction difference between basic phone based numeric paging and the enhanced EHR text paging system. Educational interruptions (averaging over 7 pages) decreased from 64% to 16%. Patient care interruptions fell from 68% to 12%. 88% of residents felt that 50% or less of the pages were non-emergent and did not require an immediate action. 92% of 25 surveyed internal medicine residents preferred text paging over numeric paging and responded through the EHR 60% of the time by placing direct orders. Time savings using the new system over a 3-month span amounted to 72.5 h in transmission time alone. Text paging among medical caregivers and internal medicine residents through EHR-associated communication reduced patient care and educational interruptions. It saved time spent sending pages, answering unnecessary pages and it improved resident’s subjective stress and satisfaction levels.     

医院数字化建设对护理工作的影响及分析

医院数字化是以患者医疗为中心,以医院全岗、全程、全面应用信息技术为基础,以管理信息化、作业网络化、医疗数字化为目标和手段,最终达到医院现有信息系统软硬件、医疗设备、管理制度及其他资源的数字化整合的现代化医院管理与服务新模式。医院数字化管理模式必将给护理工作的发展和护理工作的管理带来巨大而深刻的影响。医院引入医院数字化管理模式后,实现了护理工作流程的最优化、护理管理模式的现代化和护理管理的精细化,不仅保证了以患者为中心的护理质量与服务品质,有效促进护理科研与护理教学的发展,提升了护理工作人员的整体水平,而且还培养了护理管理者的总体管理能力。     

基于HIS的眼科诊疗质量信息系统设计

目的传统的眼科诊疗质量管理与控制体系已不能很好满足眼科医院业务不断发展的需要.为了充分发挥新管理模式的优势,提高眼科诊疗质量管理的效率,利用计算机技术模拟眼科诊疗质量的控制流程,从而提高眼科的诊疗质量.方法本文设计了一种基于医院信息系统(hospital information system,HIS)的眼科网络办公自动化信息系统,系统建立在Browser/Server/Database三层构架之上,采用ASP.NET技术开发、模块化设计.结果实现眼科诊疗信息资源共享、查询等功能和眼科科室管理功能,并且支持大型数据库,实现眼科诊疗质量控制管理功能.结论通过投入试用发现,本系统能有效地改进眼科质量管理模式,提高眼科的诊疗服务质量.     

在职护士参加志愿服务动机现状及其影响因素研究

目的:调查在职护士参加志愿服务动机现状及其影响因素.方法:采用自编一般资料问卷和志愿者功能量表对某市三级甲等综合性医院的242名在职护士进行调查.结果:不同文化程度的护士在社会维度的评分差异有统计学意义(P<0.05);不同职称的护士在保护维度的评分差异有统计学意义(P<0.05);不同科室护士参加志愿服务动机的总体评分差异有统计学意义(P<0.01),不同科室护士参加志愿服务的动机在价值、理解、增强、职业、社会、保护各维度评分差异均有统计学意义(P<0.01).结论:护士整体参与志愿服务的动机较明确,呈现积极倾向;不同文化程度、护士自身需要及工作繁忙对护士参与志愿者服务的动机均有影响.希望通过医院、护士的共同努力,提高护士参与志愿者服务活动的积极性.     

门诊预约挂号信息系统的应用

本文通过介绍门诊现场预约、自助服务预约、网站预约、短信预约、人工电话预约以及全数字智能语音预约6种预约挂号方式的实现方法和应用优缺点,分析了门诊预约挂号信息系统的应用效果,并讨论了系统需要改进的地方。     

Text Messaging (SMS) Helping Cancer Care in Patients Undergoing Chemotherapy Treatment: a Pilot Study

Cancer treatment is an extremely stressful life experience that is accompanied by a range of psychological, social, physical, and practical difficulties. Cancer patients need to receive information that helps them to better understand the disease, assists them in decision-making, and helps them deal with treatment. Patients are interested in receiving such information. The degree of satisfaction with the information received has been associated with positive health outcomes, specifically regarding quality of life, severity of side effects, and psychological well-being. This study investigates a method of guiding cancer patients, in relation to outpatient chemotherapy treatment, using SMS (short message service) text messaging. A smartphone application called cHEmotHErApp was developed, and its primary function is to send out SMS text messages with guidance for self-care and emotional support for oncology patients undergoing chemotherapy. Thus, the main objective of this study is to evaluate the acceptance and perception of patients of the receipt of these SMS messages, as well as to evaluate the possible benefits reported by the participants. Adult patients diagnosed with cancer, who started the first outpatient chemotherapy treatment scheme between August and November 2016 at the School Hospital (HE) of the Federal University of Pelotas (UFPel), were invited to participate in this pilot study. In total, 14 cancer patients were adherent to this study. Each of these patients received a daily text message on their cell phone with some guidance on encouraging self-care and emotional support. Patients reported that, because of the SMS text messages they received, they felt more confident in their treatment, felt more supported and encouraged, and that the text messages facilitated self-care. In addition, patients reported that the SMS text messages they received helped them to take better care of themselves and to continue further treatment.     

Application of Portable CDA for Secure Clinical-document Exchange

Health Level Seven (HL7) organization published the Clinical Document Architecture (CDA) for exchanging documents among heterogeneous systems and improving medical quality based on the design method in CDA. In practice, although the HL7 organization tried to make medical messages exchangeable, it is still hard to exchange medical messages. There are many issues when two hospitals want to exchange clinical documents, such as patient privacy, network security, budget, and the strategies of the hospital. In this article, we propose a method for the exchange and sharing of clinical documents in an offline model based on the CDA—the Portable CDA. This allows the physician to retrieve the patient’s medical record stored in a portal device, but not through the Internet in real time. The security and privacy of CDA data will also be considered.     

护士志愿动机的调查及医院志愿服务体系的思考

目的:调查三级甲等医院护士参与志愿服务活动的动机情况,探讨医院志愿服务体系的建立及如何有效开展志愿服务活动,为完善医院志愿服务活动提供依据.方法:采取随机抽样法,使用志愿动机量表,对某三甲医院191名护士参与志愿服务活动的情况进行调查.结果:191名调查对象中,参加过志愿服务活动有74人(38.7%),未参加过志愿服务活动有117人(61.3%);不同性别、婚姻状况的护士在志愿动机量表6个维度和志愿动机总评分差异无统计学意义(P>0.05);专科护士自我保护维度的评分最高,其余依次为中专、本科及以上护士(P<0.05);专科护士在社会交往维度的评分最高,其余依次为本科及以上、中专护士(P<0.05);自我保护维度、职业生涯维度和社会交往维度中,职称为护士评分均最高,其余依次为护师、主管护师及以上(P<0.05).191名护士在志愿动机量表6个维度的评分从高到低依次是:价值表达(4.896分)>学习理解(4.830分)>自我增强(4.819分)>职业生涯(4.576分)>社会交往(4.162分)>自我保护(4.154分).结论:护士志愿服务动机呈现多元化特点,不同需求的护士选择志愿服务活动类型不同,但参与志愿服务活动频率较低,内容较为单一,志愿服务普及率较低.医院可以建立长期的志愿服务体系,建立健全志愿者培训机制,加大志愿服务组织的宣传,从而提高志愿服务活动的频率与普及率,为社会提供专业的帮助做出贡献.     

基于C﹟.NET与ASP.NET的医院门户网站平台系统设计与开发

以西安市精神卫生中心门户网站的建立为例,应用C#.NET,ASP.NET 2.0和数据库技术,从系统结构模式、系统总体要求与技术特点、系统设计和实现几方面进行门户网站平台系统开发,促进医院信息化建设。     

医疗信息系统集成DGP研究与实践

为便于异构医疗信息系统实现协同工作和信息共享,设计了一种医疗信息系统集成平台。集成平台通过适配器与各种不同接口的信息系统交换消息,私有格式XML消息经过文档结构映射和术语转换进行规范后,从中提取临床数据存储到临床数据中心,并根据流程定义触发生成输出消息,输出消息转换成各系统能识别的私有格式消息后,经由适配器到达各信息系统。基于该平台的集成方法可使接口不一致的信息系统实现互操作,并实现系统交互流程的动态调整,为临床数据中心提供了统一格式的数据源。