RESUMO
Waiting time for chemotherapy infusion is a fundamental factor to measure quality of care. It has been shown that a prolonged waiting time is related to a higher incidence of anticipatory nausea and poor patient adherence to scheduled appointments and recommended oncology treatment programs. Some chemotherapy regimens can be prepared hours ahead-of-time, due to long stability. We aimed to study the effect of an informatic-led workflow redesign intervention, facilitating workflow changes in the Oncology Pharmacy, on patient waiting time. This intervention included changes on EHR processes and the chemotherapy CPOE. Their main effect was allowing ahead-of-time preparation of selected chemotherapy regimes. We conducted a cross sectional study, comparing waiting times pre and post intervention periods. A total of 4600 programmed chemotherapy episodes were included. We found a 26.5 % decrease in the mean wait time in the post intervention period (p > 0.02). We were able to show a decrease in waiting time and a measurable impact of the intervention. This evaluation produced valuable and actionable data for Oncology units and adds a valuable, Latin American experience to the literature.
Assuntos
Antineoplásicos , Composição de Medicamentos , Neoplasias , Listas de Espera , Humanos , Estudos Transversais , Neoplasias/tratamento farmacológico , Antineoplásicos/provisão & distribuiçãoRESUMO
The objective of this work was to explore the needs and expectations of the users of the Alexander Fleming Institute (IAF) regarding patient-oriented information systems, with the purpose of planning and prioritizing the implementation of improvements in the patient portal. The textual comments of patients who were treated at the institution between November 2021 and April 2022 and answered the satisfaction survey sent by IAF were analyzed using the content analysis technique. The results showed 6 main emerging issues: (1) the need for patients to have their clinical and administrative information in a single platform; (2) to have their clinical documentation available at the appropriate time; (3) to have clearer and more friendly information on preparation before diagnostic studies and (4) chemotherapy first time talks; (5) more accessible information on complementary treatments in the oncological context; (6) in-app appointment queue functionalities. The findings reported in this work served as an input to design an improvement plan for the patient portal and the institution's digital ecosystem.
Assuntos
Neoplasias , Portais do Paciente , Humanos , Oncologia , Motivação , Neoplasias/terapiaRESUMO
WHO and UNICEF highlight vaccination as the most cost-effective method of prevention of infectious diseases. An effective public health strategy requires efficient tracking of vaccination to assess coverage, safety, and efficacy of these vaccines. Paper-based immunization records are still being used in most low and middle-income countries. Adequate Electronic Logistic Management Information Systems, Immunization Registries and Records are crucial for proper data collection and analysis, and for making better decisions at an individual and at a population level. In this paper we share our experience in the redesign of an interoperable immunization record to track vaccination, including the recently developed vaccines for the novel coronavirus SARS-CoV-2 (COVID-19).
Assuntos
COVID-19 , Vacinas , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais , Humanos , Imunização , Programas de Imunização , Pandemias/prevenção & controle , SARS-CoV-2 , VacinaçãoRESUMO
The objective of this study was to investigate and analyze the most relevant aspects that influence the development and implementation of electronic informed consent for genetic studies. Interviews were conducted with experts in the area within our institution, the different informed consents available and the number of genetic studies requested in the last 5 years were analyzed. Professionals acknowledged the ethical dilemmas related to the genetic studies and the importance of having an electronic informed consent that not only provides the patient with the information necessary to understand the implications of the study, but also be flexible enough to adapt to the various genetic studies today. The development of informed consent is a challenge for health IT professionals, due to the complexity of the information it contains and the ethical implications it represents.
Assuntos
Consentimento Livre e Esclarecido , Pesquisa , Eletrônica , Hospitais , Humanos , Princípios MoraisRESUMO
The digital divide can hinder the ability of elderly patients to fully benefit from PHRs. They are "digital immigrants", not having the life-long exposure to technology as younger generations, as well as physical and cognitive disabilities. The aim of this study was to explore the digital divide as a barrier for the use of a PHR in older adults (> 69 years of age) and describe the use of a PHR in an elderly population in Argentina. We conducted a cross sectional study which included older adults who attended the Coronavirus vaccination campaign in 2021. Data were collected through a survey encompassing digital divide factors and use of the PHR. A total of 128 participants agreed to complete the survey, 60.15% reported using the PHR. We found a statistically significant correlation of education level, having a personal computer and internet access with PHR use. Concerning PHR users, 45.45% reported needing assistance to use it. Although the elderly population represents a large portion of patients, there is not enough research done on their use experience using eHealth solutions. There is pending work in the eHealth field to integrate these elders into current PHRs and help them enjoy their benefits.
Assuntos
Exclusão Digital , Registros de Saúde Pessoal , Idoso , Estudos Transversais , Registros Eletrônicos de Saúde , Humanos , PacientesRESUMO
Errors in medication administration involve risks to patient safety. "Bar-Coding Medication Administration" is implemented to prevent these errors. Adoption by nurses is one of the main determinants of their effectiveness. The Hospital Italiano de Buenos Aires implemented BCMA 6 years ago, but its adoption rate still finds resistance in certain sectors. We conducted semi-structured interviews with nursing staff to explore the barriers to the use in low-usage wards and explore the current perceptions of nurses. While nurses recognised the safety and usefulness of the BCMA system, they reported many difficulties. The feedback obtained through this process was useful for the implementation team to plan future interventions, priorities and improvements on the system. The semi-structured interview methodology proved useful as a continuous monitoring strategy.
Assuntos
Erros de Medicação , Processamento Eletrônico de Dados , Humanos , Erros de Medicação/prevenção & controle , Sistemas de Medicação no Hospital , Segurança do Paciente , Preparações FarmacêuticasRESUMO
The objective of this study was to investigate the difficulties and information needs that both patients and their companions have in the context of a scheduled surgery. Observations in the operating room waiting zone and semi-structured interviews were conducted to patients with scheduled surgeries, their companions, administrative staff members and surgeons. We developed a journey map to explain the patient's experience through the perioperative process. The emerging categories were Fragmented communication, Understanding the surgical process and Waiting times. Knowing the information needs of patients and companions was important to identify problems and opportunities for improvement in our institution's Personal Health Records.
Assuntos
Cirurgiões , Salas de Espera , Comunicação , Humanos , Salas CirúrgicasRESUMO
Since 2017, the Hospital Italiano de Buenos Aires, has a "Workstation on Wheels" project were nurses can access to a mobile application in order to register the drug's administration, vital signs and complete an early warning assessment scale of the hemodynamic state of the patient. Although the overall objective was to achieve at least 95% drug registration through this system, their use did not remain stable over time. Therefore, it was necessary to create an interdisciplinary team to make a diagnosis of the project situation and reasons for the low use rate. In this process, a re-implementation of the barcoding administration system was carried out, focusing on the nursing staff maintaining the use of the system over time. The aim of this paper is to describe the experience and lessons learned in the process of re-implementing the drug barcoding system at the patient's bedside.