新颖的电子健康记录为基础的咨询工作流程，提高了时间到手术室的手术患者在急性设置

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-05-02 DOI:10.1016/j.amjsurg.2025.116386

Micaella R. Zubkov , John Iguidbashian , Zhixin Lun , Kyle Bata , Lauren Gunn-Sandell , Derek Crosby , Kristin Stoebner , David Tharp , Linda Staubli , Ct Lin , Ethan Cumbler , Jennifer Wiler , Robert C. McIntyre Jr. , Jeniann Yi

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引用次数: 0

摘要

为了提高创伤或急性护理外科（TACS）会诊患者住院外科会诊过程的效率，在一家第四专科转诊中心实施了一种新的基于电子健康记录（EHR）的工作流程。方法采用ehr驱动的会诊流程，实现患者信息的自动通知、沟通和数据跟踪。比较实施前（2020年1月1日- 2022年1月31日）、实施后早期（2022年2月1日- 2023年1月31日）和实施后晚期（2023年2月1日- 2024年1月31日）队列的护理及时性。结果在5724例咨询中，2658例需要手术（手术前733例，术后早期830例，术后晚期1095例）。从会诊到手术室的时间在实施后减少了27%(术前= 726分钟；早期post = 577；后期职位= 532；p & lt;0.001)和48% (pre = 531 min；早期岗位= 290；后期职位= 277；p & lt;0.001)用于紧急/紧急病例。实施后住院时间缩短，30天临床结果无差异。结论新型EHR会诊工作流程的实施是安全的，并且缩短了到手术室的时间，这在实施后阶段持续存在，对需要紧急/紧急手术的患者影响最大。

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Novel electronic health records-based consultation workflow improves time to operating room for surgery patients in an acute setting

Background

A novel electronic health records (EHR)-based workflow was implemented at a quaternary referral center to improve the efficiency of inpatient surgical consultation processes for patients requiring trauma or acute care surgery (TACS) consultation.

Methods

The EHR-driven consultation workflow automated notifications, communication of patient information, and data-tracking. Timeliness of care was compared between pre-implementation (1/1/2020-1/31/2022), early post-implementation (2/1/2022-1/31/2023), and late post-implementation (2/1/2023-1/31/2024) cohorts.

Results

Of 5724 consultations, 2658 required surgery (733 pre-, 830 early post-, 1095 late post-implementation). Time between consult to OR was reduced overall by 27 % post-implementation (pre = 726 min; early post = 577; late post = 532; p < 0.001) and by 48 % (pre = 531 min; early post = 290; late post = 277; p < 0.001) for urgent/emergent cases. Length of stay decreased post-implementation with no difference in 30-day clinical outcomes.

Conclusion

Implementation of the novel EHR consultation workflow was safe and associated with decreased time-to-OR, which persisted throughout the post-implementation phase with greatest impact on patients requiring urgent/emergent operations.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.