Does computerised provider order entry reduce test turnaround times? A before-and-after study at four hospitals

Few multi-centre studies of the impact of computerised provider order entry (CPOE) systems on health care efficiency and effectiveness exist. Further, demonstrating a link between system use and improvements in patient outcomes is challenging. An often neglected step is to characterise the nature of the problem prior to CPOE introduction to ensure that the 'problem' being addressed has a demonstrated impact on the outcome of interest. We undertook a two-staged project to i) investigate the link between test turnaround time (TAT) and length of stay for emergency department patients prior to CPOE; ii) to measure the impact of CPOE on TAT in four Australian hospitals to examine the consistency of findings. We found TAT is a significant contributor to length of stay. All four hospitals experienced a significant reduction in TAT following CPOE. This study presents evidence that TAT is directly related to length of stay and that CPOE systems are effective at reducing TAT. These results add weight to the hypothesis that the introduction of CPOE may positively impact upon patient outcomes.5 page(s

Mapping Turnaround Times (TAT) to a Generic Timeline: A Systematic Review of TAT Definitions in Clinical Domains

<p>Abstract</p> <p>Background</p> <p>Assessing turnaround times can help to analyse workflows in hospital information systems. This paper presents a systematic review of literature concerning different turnaround time definitions. Our objectives were to collect relevant literature with respect to this kind of process times in hospitals and their respective domains. We then analysed the existing definitions and summarised them in an appropriate format.</p> <p>Methods</p> <p>Our search strategy was based on Pubmed queries and manual reviews of the bibliographies of retrieved articles. Studies were included if precise definitions of turnaround times were available. A generic timeline was designed through a consensus process to provide an overview of these definitions.</p> <p>Results</p> <p>More than 1000 articles were analysed and resulted in 122 papers. Of those, 162 turnaround time definitions in different clinical domains were identified. Starting and end points vary between these domains. To illustrate those turnaround time definitions, a generic timeline was constructed using preferred terms derived from the identified definitions. The consensus process resulted in the following 15 terms: admission, order, biopsy/examination, receipt of specimen in laboratory, procedure completion, interpretation, dictation, transcription, verification, report available, delivery, physician views report, treatment, discharge and discharge letter sent. Based on this analysis, several standard terms for turnaround time definitions are proposed.</p> <p>Conclusion</p> <p>Using turnaround times to benchmark clinical workflows is still difficult, because even within the same clinical domain many different definitions exist. Mapping of turnaround time definitions to a generic timeline is feasible.</p

Fase pré-analítica laboratorial : erros e recomendações

Orientadora : Profa. Dra. Dayane AlbertonMonografia (especialização) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Curso de Especialização em Análises ClínicasInclui referênciasResumo : O erro laboratorial pode ser definido como qualquer falha durante o processo laboratorial. A fase pré-analítica é responsável por mais de dois terços de todos os erros atribuídos ao laboratório clínico. Os erros podem ocorrer em vários processos, como na solicitação do exame, coleta ou flebotomia, identificação das amostras, transporte, preparação e armazenamento das mesmas e, todos esses erros podem ser minimizados se forem seguidas algumas recomendações. A complexidade e a heterogeneidade dos erros pré-analíticos, mesmo com o avanço da ciência e tecnologia, ainda representam uma grande preocupação para os laboratórios clínicos, médicos e instituições de saúde. Melhorar a qualidade de amostras de sangue na fase pré-analítica é a chave para a prevenção ou a redução de erros. Portanto, o reconhecimento e o gerenciamento das possíveis variações biológicas e fatores préanalíticos podem auxiliar o laboratório e o clínico alcançarem um resultado seguro, preciso e eficaz