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Patient-scheduling methodologies.

Inpatient admissions, surgical scheduling, and outpatient scheduling are three of the most important patient-scheduling functions in the hospital. In this paper, the key elements of state-of-the-art scheduling systems are discussed, along with a rationale for their importance. Our purpose is to show how well-designed patient-scheduling systems can contribute to the improvement of hospital operations.

Admitting Department, Hospital

The dangers resulting from inaccurate computer-based operative records.

The accuracy of a computer-based recording system of operative procedures was audited at a major district general hospital. The system is supposed to provide accurate records of theatre activity, to allow for improved nursing resource allocation and provide surgeons with a basic record of their operations. Mistakes were present in the details of 27% of the cases entered. Such inaccuracies highlight a major danger to surgeons with regard to their accountability for operations attributed to them. Mistakes can only cause further problems with regard to audit and future resource allocation.

Documentation

[Use of information systems for direct surgical patient management].

The aim of this prospective study was to evaluate the use of a modern computer-based hospital information system for the management of patients in our surgical department. The results showed that the information system was well accepted by the medical staff and found to be useful throughout daily work. In addition, they justify the effort to install and maintain such a system.

Attitude to Computers

[A new software for handling surgical data in strabology].

BACKGROUND: Numerous measurements and data are the hallmark of strabismology. Handling these data is greatly facilitated by the use of computers. An adequate software should also allow surgical results analysis and quality control. Standardisation of data is mandatory. METHODOLOGY: We developed such an application based on a commercially available database (4th Dimension, ACI Paris). It uses 5 relational files. RESULTS: This software is userfriendly and can be used by anyone. No special code is necessary to enter data and these values are automatically verified. Patient's data, diagnosis, type of surgery and angle measurements (pre- and post surgery) can be entered, usually by an orthoptist, right after examination. CONCLUSION: Numerisation of strabologic surgical data can be easily realised with the help of a programmable database, but rigorous terminology is mandatory. Indeed the use of a strict terminology is helpful in teaching hospitals.

Computer Graphics

Will we see automated record keeping systems in common use in anesthesia during our lifetime? The automated anesthetic record is inevitable and valuable.

The automated anesthetic record is inevitable for at least three reasons: First, much of the information is in electronic form. Second, all the necessary tools for transferring this information into a computer and hence onto a piece of paper are already available. Third, the need for an improvement over the current way of keeping records is widely recognized. Manual records are often inaccurate, biased, incomplete, and illegible, and they divert attention from more important tasks of the anesthetist. Although automated record keeping will not produce perfection, it will improve the situation enough to justify the effort.

Anesthesia

Systematic planning of clinical documentation.

All information obtained from a patient in the course of medical care is a potential part of clinical documentation. The documentation usually serves a number of different purposes. The task of a documentation system is to fulfil these purposes in a methodically correct manner and as economically as possible. This requires that the properties of the documentation system be planned systematically with a view to the goals pursued. To support systematic planning, a "documentation protocol" is proposed analogous to the "study protocol" used for controlled clinical trials. The individual sections of the proposed documentation protocol are described and the design options which exist in the corresponding planning phases are pointed out. Experience gained by the application of the documentation protocol is discussed.

Data Collection