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At least 253 records · Page 14Linked to original sources
PubMed2002

Leveraging on information technology to enhance patient care: a doctor's perspective of implementation in a Singapore academic hospital.

Information technology (IT) can improve the safety of patient care by minimising prescribing errors and organising patient-specific information from diverse databases. Apart from legibility, prescribing safety is enhanced as online access to databases carrying patient drug history, scientific drug information and guideline reference, and patient-specific information is available to the physician. Such specific information includes discharge summaries, surgical procedure summaries, laboratory data and investigation reports. In addition, decision support and prompts can be built in to catch errant orders. For such system implementations to work, the IT backbone must be fast, reliable and simple to use. End-user involvement and ownership of all aspects of development are key to a usable system. However, the hospital leadership must also have the will to mandate and support these development efforts. With such support, the design and implementation team can then map out a strategy where the greatest impact is achieved in both safety and enhanced information flow. The system should not be considered a finished work, but a continual work in progress. The National University Hospital's continuously updated Computerised Patient Support System (CPSS) is an example of an IT system designed to manage information and facilitate prescribing. It is a client-server based, one-point ordering and information access portal for doctors that has widespread adoption for drug prescription at outpatient and discharge medication usage areas. This system has built in safety prompts and rudimentary decision support. It has also become the choice means of accessing patient-related databases that impact on diagnoses and management.

Attitude of Health Personnel↗
PubMed2003

Mental health. Pay attention.

Research into user involvement groups in mental health was conducted to make them more effective. Responses revealed frustration about a lack of real input, use of volunteers, lack of payment and burn-out of activists. The responses also revealed a widespread feeling of 'influence without power'.

Health Services Research↗
PubMed2003

Multidimensional evaluation of a Clinical Information System for anaesthesiology: quality management, usability, and performances.

This paper describes a multi-dimensional assessment methodology to support the choice and selection process of Clinical Information Systems. The methodology includes 4 evaluation components: Fulfilment of Users Requirements, Usability Inspection, Usability Testing and Performance Evaluation. The methodology is illustrated with the case study of a selection of a CIS for anaesthesiology. It proved to be very efficient and powerful to support the selection process, to enhance users' involvement in the project, and to initiate the necessary re-engineering of the HCI.

Anesthesia Department, Hospital↗
PubMed2004

Patients as teachers: the patient's role in improving cancer services.

The NHS Plan stipulates that health care in the 21st century should reflect the needs and expectations of local people, offer greater choice and involve patients in the planning and provision of services. This paper describes an initiative to involve users of cancer services in educating health-care professionals because patients are the experts on their condition.

Attitude of Health Personnel↗
PubMed2004

Towards responsive IT-infrastructures--assessment of a health information system.

Marburg University Medical Center has been introducing a comprehensive health information system since 1999, using a single-vendor application framework with an integrated generator tool for the development of clinical applications. To find out if this architecture and our participative software engineering approach can be considered a step towards a responsive infrastructure, we compared the situation after the first deployment phase (basically a holistic approach) with the situation after the system was further developed and adapted to the users' needs using the generator tool approach. We collected system statistics and conducted user satisfaction surveys in 2001/02 and 2003 using standardized measurements. The survey results showed that user involvement as well as system content were judged significantly higher after the second deployment phase. Insofar, we could demonstrate the feasibility of our approach. However, definite statements concerning the superiority of the generator tool approach to other concepts are not yet possible. We will continue our assessment, and we strongly suggest further studies in other institutions introducing comparable clinical functionality.

Academic Medical Centers↗
PubMed2004

The development of a short instrument to identify common unmet needs in older people in general practice.

BACKGROUND: No structured needs assessment tool exists that is appropriate for older people and also suitable for use in routine consultations in general practice. AIMS: To engage older people in the development of a brief, valid, practical, and acceptable instrument to help identify common unmet needs suitable for use in routine clinical practice in primary care. DESIGN OF STUDY: User involvement in a multi-stages approach to heuristic development. SETTING: General practices, voluntary groups, and community organisations in north and central London. METHOD: Subjects included patients aged 65 years and over in purposively selected practices, voluntary organisations for older people in the same localities, community organisations involving older people, general practitioners and community nurses. Data were collected through mixed methodology interviews using a structured assessment tool (Camberwell Assessment of Need for the Elderly), a postal questionnaire, and focus groups. Synthesis and interpretation of results was done through a consensus conference followed by a Delphi process involving primary care professionals. RESULTS: Five domains of unmet need were identified as priority areas by all three data collection methods, the consensus conference, and the Delphi process: senses (vision and hearing), physical ability (mobility and falls), incontinence, cognition, and emotional distress (depression and anxiety) (SPICE). CONCLUSIONS: Public involvement in the design of clinical tools allowed the development of a brief assessment instrument that could potentially identify common, important, and tractable unmet needs in older people.

Aged↗
PubMedDate not supplied

The nurse's role in contributing to new device development.

Nurses are in an ideal position to use their clinical observations to highlight unmet needs in relation to device use. This paper explores issues that relate to medical devices. An overview is given of the medical device field and examples are given from a survey of the healthcare literature to determine the level of user involvement in device development.

Clinical Competence↗
PubMed1991

A common and clonable environment to support research using patient data.

The volume and complexity of information systems for data oriented clinical research at Mayo Clinic began to exceed available database-analyst resources. A decision was made to generate a clonable, generic system for health services research; this was implemented for a medium-sized prototype project. Since 1988, it has been reconfigured to support several score data projects at less than one-tenth the cost for database analysts. Further, user involvement and empowerment has increased their satisfaction and inquiry abilities with their specific systems.

Data Interpretation, Statistical↗
PubMed1980

Installing a computer-based patient information system.

Extensive planning and coordination are the keys to successful implementation of a hospital-wide, computer-based patient information system. With user involvement, problems can be minimized and benefits realized. Nursing administrators can avoid common pitfalls by following the example of one hospital staff in meeting the challenge of computerization.

Humans↗
PubMed1996

Comparing and using assessments of the value of information to clinical decision-making.

This paper discusses the Value project, which assessed the value to clinical decision-making of information supplied by National Health Service (NHS) library and information services. The project not only showed how health libraries in the United Kingdom help clinicians in decision-making but also provided quality assurance guidelines for these libraries to help make their information services more effective. The paper reviews methods and results used in previous studies of the value of health libraries, noting that methodological differences appear to affect the results. The paper also discusses aspects of user involvement, categories of clinical decision-making, the value of information to present and future clinical decisions, and the combination of quantitative and qualitative assessments of value, as applied to the Value project and the studies reviewed. The Value project also demonstrated that the value placed on information depends in part on the career stage of the physician. The paper outlines the structure of the quality assurance tool kit, which is based on the findings and methods used in the Value project.

Cost Savings↗
PubMedDate not supplied

[Prospects of therapeutic intervention in drug addiction in prisons].

The non-penalization envisaged by the new law concerning the use and possession of drugs, will not cause the population of drug addicts to disappear from the prisons; it is however to be expected a qualitative modification of them, with the drug addicts clinically in most serious and persistent conditions and more involved with the criminal subculture, gradually increasing in number. Such individuals will represent a group of potential customers much different from that found up to now, and their more meaningful features will concern their age (higher), polytoxicomania (almost always resulting in heroinism), the abandonment of all family ties, of the pristine social and cultural status, of work, to acquire a new role, where identity is extremely ambiguous and uncertain. As concerns the treatment hypotheses, the less involved users being no longer dealth with--upon whom the attention of operators had been chiefly centered, and on whom the prospects of a psychotherapeutic success had been founded--only two solutions are regarded as implementable in the future: either to give up all intramural treatments, with the exception of those having a medical character, and, extramurally, to provide for the supply (controlled and through dispensaries) of heroin or substitute drugs, so as to reduce as much as possible the danger drug addicts represent for society; or to establish therapeutic or intramural communities, forming the one instrument capable of suggesting or conditioning new identity patterns, as an initial stage of an analogous institutional treatment to be continued when the convict leaves the prison.

Drug and Narcotic Control↗
PubMed1998

Modeling utilization of planned information technology.

The antecedents of technology use involve user, system, task and organization characteristics as well as externalities which can affect all of these entities. Evaluation of all entity attributes would be impossible; however, measurement of the interaction effects between these entities can act as a proxy for individual attribute values. A model is proposed which, based upon evaluation of these interaction effects, should predict technology utilization. This model will provide insight into the relationship between the antecedents of technology utilization. Also, application of the approach described can provide a predictive model and taxonomy of variables which can be applied to predict or manipulate the likelihood of utilization for planned technology.

Attitude to Computers↗
PubMed2005

Designing and implementing an electronic health record system in primary care practice in sub-Saharan Africa: a case study from Cameroon.

OBJECTIVE: To review the key issues related to the design and implementation of an electronic health record (EHR) system in urban primary health care (PHC) practice in Cameroon. METHODOLOGY: The goal of the project was to assess EHR as a tool to improve providers' performance, quality and continuity of care, and the availability of data in PHC practice in Cameroon. A locally designed EHR system called MEDCAB was developed. The system was based on the International Classification for Primary Care (ICPC) and was designed taking into consideration the PHC practice environment in Cameroon. An original cohort of 14 users was involved in the experiment. RESULTS: Users generally showed good acceptance of the system. Monitoring the use of the system at the early stages of implementation was important to ensure immediate response to users' comments and requests. Some of the key issues identified during the development and implementation of the system were: user involvement, the choice of an appropriate terminology, pre-existing data collection culture and leadership issues. Some positive achievements brought about by the system included promotion of good medical practice and routine availability of consultation data. CONCLUSION: Strengthening the medical record in general, and the EHR in particular, could contribute to its position as a valuable source of information for healthcare delivery, public health and policy making in Cameroon. Challenges to adoption are huge and successful implementation for any specific setting will require a comprehensive modelling of the local medical practice, the choice of an appropriate terminology and a co-ordinated approach involving all stakeholders.

Africa South of the Sahara↗
PubMed1993

Criminal involvement of cocaine users enrolled in a methadone treatment program.

This was a study of criminal activities of cocaine users versus non-users enrolled in a methadone treatment program in New York City. Of those 140 methadone clients studied, 100 (71%) were cocaine users. There were no demographic differences between the two groups except marital status. Married clients (including common-law married) were more likely than never-married single clients to be non-users. Cocaine users were significantly more depressed, using the subscale of the Symptom Checklist-90. Although numbers of lifetime arrests and criminal involvement (in the year immediately preceding the research interview) of cocaine non-users were distinctively lower than those of users, the differences were not significant. In a multiple regression analysis, length of stay in the methadone program was the strongest predictor of criminal involvement. Those who were retained longer in the treatment were significantly less likely to be involved in criminal activities, regardless of cocaine use.

Adult↗
PubMed2006

User and carer involvement in the training and education of health professionals: a review of the literature.

BACKGROUND: Health policy requires consumer involvement in services, research and education but little is known about how consumers are being involved in healthcare education, the effect on learning and practice, nor how involvement initiatives are being evaluated. OBJECTIVES: To describe methods of involving consumers in healthcare education, discuss ways in which initiatives have been evaluated, and identify areas for development in education, practice and research. DESIGN: All papers reporting specific initiatives involving consumers in health care worker training and education were included. Viewpoint articles and studies of consumers training consumers were excluded. DATA SOURCES: Cinahl, Medline, Assia, PsycINFO, British Nursing Index, Social Science Citation Index, citations from reference lists, relevant websites and personal communication with key people known to be working in this area. REVIEW METHODS: A narrative approach was taken with categorisation of data to reflect objectives of selected studies; method of involvement; process issues and evaluation. RESULTS: Thirty-eight papers were included; most provide small-scale qualitative studies of mental health service users and focus on process rather than outcome. Various methods of involvement are described and consumers consistently prioritise the need for training in interpersonal skills over 'technical' skills. There is little research into organisational strategies and no studies investigate the effect of consumer involvement on practice. Two studies indicated that students exposed to consumer involvement demonstrate more empathic understanding and better communication skills. CONCLUSIONS: There is tentative evidence that consumer involvement in training enhances workers' skills in the manner prioritised by consumers. However, if consumer involvement in training and education is to facilitate services that reflect the priorities of the people using them, it must be developed in partnership with service providers; further research is needed to explore the impact of consumer involvement and to track the development of organisational consumer involvement strategies, also systems for supporting consumers need to be established, including training for both consumers and staff.

Attitude of Health Personnel↗
PubMed2006

Experiences of service user and carer participation in health care education.

The agenda of involving service users and their carers more meaningfully in the development, delivery and evaluation of professional education in health is gaining in importance. The paper reports on a symposium which presented three diverse initiatives, established within a school of nursing and midwifery in the United Kingdom. These represent different approaches and attempts to engage service users and in some instances carers more fully in professional education aimed at developing mental health practitioners. Each is presented as achieving movement on a continuum of participation from service users as passive recipients to service users as collaborators and co-researchers. The paper concludes with a discussion of the lessons to be learnt which will hopefully stimulate service user involvement on a wider basis.

Attitude of Health Personnel↗
PubMedDate not supplied

How users and carers view their involvement in nurse education.

User and carer participation in health care is central to care planning and delivery. From an educational perspective, their input is beneficial in terms of enhancing the quality of the education process. The study reported in this paper explored the experiences of user and carer participation in nurse education from the perspective of the key stakeholders involved in the process. By pinpointing key issues of concern for participants, the study aims to help inform the ongoing development of practice in this area.

Attitude of Health Personnel↗