Quality Improvement Targeting Early Phase of Hepatitis C Care Delivery

Liver fibrosis evaluation is one of the most important assessments in patients with chronic hepatitis C. In an inner-city infectious disease clinic, more than 30% of patients with hepatitis C did not have complete evaluation for liver fibrosis, potentially leading to negative clinical outcomes. A quality improvement project was developed to improve and standardize liver fibrosis evaluation through the implementation of an order set in the electronic medical record. The implementation of the electronic order set was effective in improving the fibrosis evaluation completion rate by more than 20% (P = 0.016).     

给药错误事件根因类型信息指标的确定与电子上报系统设计

目的确定给药错误事件电子上报系统的根因类型信息项,以实现事件根因类型分析的结构化、自动化。方法参考根因分析理论框架,研究小组初步拟定给药错误事件根因类型信息项并形成函询问卷,以德尔菲法确定给药错误事件根因类型结构化信息内容,由软件工程师根据上报表模块设计需求,开发给药错误事件根因分析结构化电子上报系统。结果给药错误事件电子上报表根因类型结构化信息内容有激发问题(一级指标)18项,提示答案(二级指标)84项;开发的电子上报系统有上报模块和报表模块,报表模块有查询和分析功能。结论确定的根因类型信息涵盖了质量管理的主要因素,上报系统能帮助护理管理者快速、有效地查寻给药错误事件的根本原因,并根据高发原因采取针对性管理措施,提高管理效率及效能。     

Knowledge and attitudes regarding the personally controlled electronic health record: an Australian national survey

The personally controlled electronic health record (PCHER) was designed to bring important information together to facilitate effective communication between clinicians and so improve patient care. This national cross‐sectional survey of 405 healthcare providers and consumers found that they had relatively low awareness and knowledge about the PCEHR; that 62% of respondents believed that healthcare providers with access to the PCEHR would be able to provide better quality of care but only 50% of respondents would sign up to have a PCEHR.