Leigh Anne Bakel1, Karen Wilson2, Amy Tyler2, Eric Tham3, Jennifer Reese2, Joan Bothner4, David W Kaplan5. 1. Department of Pediatrics-Hospital for Sick Children, Toronto, Ontario leighanne.bakel@sickkids.ca. 2. Department of Pediatrics-Section of Hospital Medicine. 3. Department of Pediatrics-Sections of Emergency Medicine Department of Pediatrics-Section of Clinical Informatics, and. 4. Department of Pediatrics-Sections of Emergency Medicine. 5. Department of Pediatrics-Section of Adolescent Medicine, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado.
Abstract
BACKGROUND: The problem list is a meaningful use incentivized criterion, and >80% of patients should have 1 problem entered as structured data. OBJECTIVE: The aim of the present study was to use a series of interventions to increase the use of the problem list for inpatients to >80% as measured by at least 1 hospital problem at discharge. METHODS: This study was a quasi-experimental time series quality improvement trial. The primary outcome was 80% of medical and psychiatric inpatients with a problem added to the problem list before discharge. Control charts of percentage (p charts) of medical and psychiatric patients with an inpatient problem list at discharge were constructed with three-σ control limits. Control limits were revised after evidence of improvement. The charts were annotated with interventions, including increasing awareness, focused education, and timely feedback in the form of performance graphs e-mailed to providers. RESULTS: For medical inpatients, use rose from 31% to 97% at its peak in April 2011 and continues to maintain above the goal of 80%. In psychiatry, problem list use rose from 2% initially to an average of 72% after the interventions. CONCLUSIONS: Significant gains were made with inpatient problem list usage by the medical and psychiatric teams. Our goal ascribed by meaningful use for >80% of inpatients to have a problem at discharge was met after initiation of our series of interventions.
BACKGROUND: The problem list is a meaningful use incentivized criterion, and >80% of patients should have 1 problem entered as structured data. OBJECTIVE: The aim of the present study was to use a series of interventions to increase the use of the problem list for inpatients to >80% as measured by at least 1 hospital problem at discharge. METHODS: This study was a quasi-experimental time series quality improvement trial. The primary outcome was 80% of medical and psychiatric inpatients with a problem added to the problem list before discharge. Control charts of percentage (p charts) of medical and psychiatricpatients with an inpatient problem list at discharge were constructed with three-σ control limits. Control limits were revised after evidence of improvement. The charts were annotated with interventions, including increasing awareness, focused education, and timely feedback in the form of performance graphs e-mailed to providers. RESULTS: For medical inpatients, use rose from 31% to 97% at its peak in April 2011 and continues to maintain above the goal of 80%. In psychiatry, problem list use rose from 2% initially to an average of 72% after the interventions. CONCLUSIONS: Significant gains were made with inpatient problem list usage by the medical and psychiatric teams. Our goal ascribed by meaningful use for >80% of inpatients to have a problem at discharge was met after initiation of our series of interventions.
Keywords:
care standardization; communication; electronic medical record; electronic problem list; information technology; problem list; problem lists; quality improvement
Authors: D R Vinson; J E Morley; J Huang; V Liu; M L Anderson; C E Drenten; R P Radecki; D K Nishijima; M E Reed Journal: Appl Clin Inform Date: 2015-05-13 Impact factor: 2.342
Authors: Bat-Zion Hose; Peter L T Hoonakker; Abigail R Wooldridge; Thomas B Brazelton Iii; Shannon M Dean; Ben Eithun; James C Fackler; Ayse P Gurses; Michelle M Kelly; Jonathan E Kohler; Nicolette M McGeorge; Joshua C Ross; Deborah A Rusy; Pascale Carayon Journal: Appl Clin Inform Date: 2019-02-13 Impact factor: 2.342