Measuring the Effectiveness of eHealth Initiatives in Hospitals
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Prof Johanna Westbrook Health Informatics Research & Evaluation Unit, The University of Sydney www.fhs.usyd.edu.au/hireu/ (2/10/09, Forum, 10.50)
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Measuring the Effectiveness of eHealth Initiatives in Hospitals
- 1. Measuring the effectiveness of e-health initiatives in hospitals Prof Johanna Westbrook Health Informatics Research & Evaluation Unit The University of Sydney
- 8. Changes in TAT post CPOE in four hospitals
- 11. “… I don’t have figures to prove this, but in my estimation it has made the turnaround time longer.” (Senior scientist, 2004)
- 13. Benefits realisation framework Georgiou A, et al (2007) The impact of computerised physician order entry systems on pathology services: a systematic review. Intern J Med Informatics 76 (7), 514-529. Georgiou et al. (2008) Electronic test management systems and hospital pathology services – a framework for investigating their impact. Encyclopaedia of Healthcare Information Systems Efficiency Effectiveness Quality Test costs Redundant test rates Turn around times Work practices Patient safety Compliance with guidelines Patient management Length of stay Test volumes Communication
- 14. Will electronic medication management systems make our health services safer?
- 16. Controlled Before & After study 2 Hospitals 2 Systems 6 wards
- 22. Aim: To develop a reliable method for observing and recording time spent by clinicians in different work tasks Work Observation Method By Activity Timing (WOMBAT) Westbrook JI, Ampt A (2009) Design, application and testing of the Work Observation Method by Activity Timing (WOMBAT) to measure clinicians’ patterns of work and communication. International Journal of Medical Informatics. 78S, S25-S33.
- 23. PDA data collection tool What task? With whom? With what? Interruptions Multi-tasking
- 25. Proportions of observed time in tasks across four wards ( Before)
- 27. Distribution of doctors’ tasks over the day 2006
- 28. Distribution of doctors’ tasks over the day including social tasks 2006
- 30. Challenges of integrating the use of technology into everyday work practices
- 31. Poor mobility workarounds may result in less safe practices
- 32. Paper is a highly mobile technology!
- 34. Computers on wheels 82% of nurses’ tasks 3% of nurses’ work tasks
Editor's Notes
- We are undertaking an observational study of medication preparation and administration processes in a large teaching hospitals in order to identify the extent of medication errors and the relationship of interruptions to error rates. We are focusing on IV medications due to the reported overseas data on error rates. Only 1 small scale Aust study has been published. We have a 2 stage method - Researchers follow nurses on the ward and record rugs administered, procedural errors and any interruptions Stage 2 observed data is compared with patients medication charts to identify errors. We are using a PDA we designed especially for this study. One of our recently technical problems with this tool was that we had anticipated that any nurse would be interrupted more than 13 times while trying to administer one drug, but we were wrong and have had to adjust the system accordingly.