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Patient care redesign involves people, processes and technology coming together to meet or exceed patient expectations. A centralized communication system promotes professional nursing practice and optimizes all the team members' roles through more efficient use of staff.
The concept of one total telecommunications system to serve an entire hospital is not practical. Hospitals should plan toward the establishment of an integrated telecommunications plan and network that would incorporate four or more major telecommunications support systems.
This paper has shown how modern digital technology is being applied to nurse call systems and how integrated bed head services can be provided using the minimum number of cables and offering the maximum facilities within a very modest cost increase.
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A computerized hospital information system as applied to a centralized intravenous admixture service in a 525-bed hospital is described. A comparison between the i.v. admixture service prior to and after the installation of the system is presented. The computerized system increased the accuracy, completeness, legibility and timeliness of data communication throughout the hospital.
OBJECTIVE: Many emergency departments that perform a high volume of group A Streptococcus throat cultures inform patients or parents that unless they are notified of a positive result they can assume that their throat culture result is negative. Thus, positive throat culture results are communicated actively and negative results are communicated passively. We sought to determine the effectiveness and safety of such a system. METHODS: Prospective cohort study of 301 consecutive patients who had group A Streptococcus throat cultures obtained between March 28, 2000, and May 10, 2000, in the emergency department of an urban, academic, tertiary-care children's hospital. Outcomes were determined by telephone surveys of patients or their parents or guardians. The primary outcome was whether respondents had accurate knowledge of the throat culture result. Secondary outcomes included receipt of appropriate treatment instructions, need for another telephone call to the emergency department or primary-care provider to clarify the result or treatment instructions, satisfaction with the communication process, and preference to receive both positive and negative results or just positive results. RESULTS: Fifty-three percent of respondents did not have accurate knowledge of the throat culture result, 5% received inappropriate treatment instructions, 13% sought further clarification, 29% were dissatisfied with the communication process, and 85% preferred to receive both positive and negative results. Parents of patients with positive results were more likely to have accurate knowledge of the result (odds ratio 6.9, 95% confidence interval 1.4-65.7) and to be satisfied with the communication process. CONCLUSIONS: Passive communication of negative throat culture results to patients seen in the emergency department can be unreliable. Active communication of both positive and negative results may improve patient knowledge and satisfaction and ensure appropriate therapy, but in the absence of automated notification systems, would be resource intensive.
The goals of a surveillance for nosocomial infections are to observe the magnitude and characteristics of the infections, and to plan and evaluate policies and guidelines of infection control. In clinical laboratory, although it is most important to detect their causative pathogens, further to provide the surveillance study as a multicenter. Actually, we have just started an infection control room in our hospital. Thus this room may present various informations about infection and contribute to the networks with the area community.
The operational reliability of the picture archiving and communication system (PACS) server in a filmless hospital environment is always a major concern because server failure could cripple the entire PACS operation. A simple, low-cost, continuous-availability (CA) PACS archive server was designed and developed. The server makes use of a triple modular redundancy (TMR) system with a simple majority voting logic that automatically identifies a faulty module and removes it from service. The remaining two modules continue normal operation with no adverse effects on data flow or system performance. In addition, the server is integrated with two external mass storage devices for short- and long-term storage. Evaluation and testing of the server were conducted with laboratory experiments in which hardware failures were simulated to observe recovery time and the resumption of normal data flow. The server provides maximum uptime (99.999%) for end users while ensuring the transactional integrity of all clinical PACS data. Hardware failure has only minimal impact on performance, with no interruption of clinical data flow or loss of data. As hospital PACS become more widespread, the need for CA PACS solutions will increase. A TMR CA PACS archive server can reliably help achieve CA in this setting.
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As hospital radiology departments expand their use of digitally formatted imaging devices, these machines will be connected in local area networks called Picture Archival and Communications Systems (PACS). The purpose of this paper is to demonstrate the use of computer simulation to analyze the process of patients using a PACS. The flexibility of using simulation on a proposed PACS is shown, starting with the description of a basic model. Different machine networks are run and the results compared. Simulation modeling provides a valuable tool to hospital and department administrators in detecting possible problem areas which may occur with proposed PACS configurations under assumed patient loads.
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