Why Don’t Information Industries Make a Greater Impact on Care Delivery?

Dr. Terry Young , Professor of Healthcare Systems, School of Information Systems, Computing and Mathematics, Brunel University

He and Dr. James Fackler published a paper  Why healthcare professionals are slow to adopt modeling and simulation?  to explore the reason for slow adoption of the computer modeling and simulation in healthcare.

Professo Young is also the co-founder of the Cumberland Initiative, a network of leading clinicians, managers, modellers, academics and industry specialists who are pioneering the modeling and simulation approach in the NHS. Lord Norman Warner, former Health Minister for NHS reform said in a press conference. 

“We will only do something different if we have an analytical base to enable people to change,” argued Lord Warner. “The problem in the NHS is, unless local people are confronted with overwhelming evidence that something has to be done and there is another way, in many places they don’t change their institutional behaviour.” 

The NHS is a very conservative organisation in many places. But where we are now, we badly need the kind of initiative that Cumberland is showing. The traditional thing you do is try and gee up doctors and managers but we need a bit of an injection of data collection and analysis.”

Short-term and Long-term Impact of the Central Line Workshop on Resident Clinical Performance During Simulated Central Line Placement.

Our paper just published at Simulation in Healthcare Journal.   The study demonstrated earlier simulation training offered greatest benefits.

INTRODUCTION:  The Central Line Workshop (CLW) was introduced at our institution to better train residents in safe placement of the central venous catheter (CVC). This study sought to determine if immediate performance improvements from the CLW are sustained 3 months after the training for residents with various levels of experience.

METHODS: Twenty-six emergency medicine residents completed the CLW, which includes online modules and experiential sessions in anatomy, ultrasound, sterile technique, and procedural task training. Demonstration of the synthesis of these skills including placement of both internal jugular and subclavian CVCs was assessed using a task trainer. Each resident was also tested approximately 3 months before and 3 months after the CLW. Residents were assessed using a validated CVC proficiency scale.

RESULTS: Residents’ CVC proficiency scores (percentage of items performed correctly during the assessment station) improved after CLW (0.6 vs. 0.93, P < 0.05). At 3 months after CLW testing, there was apparent skill decay from the CLW but overall improvement compared with baseline testing (0.6 vs. 0.8, P < 0.05). There was no significant difference in procedure time after CLW training. The postgraduate year 1 group showed the greatest improvement of CVC skill after CLW training.

CONCLUSIONS: Resident CVC placement performance improved immediately after the CLW. Although performance 3 months after the CLW revealed evidence of skill decay, it was improved when compared with initial baseline assessment. Novice learners had the greatest benefit from the CLW.

Systems Modeling and Simulation Applications for Critical Care Medicine

Here is our recently published review paper on Annals of Intensive Care

Systems Modeling and Simulation Applications for Critical Care Medicine

Research Review Finds Simulation an Effective Way to Train Health Care Professionals

An analysis led by Dr. David A Cook and other researchers found that simulation-based training is an effective way to teach physicians, nurses, dentists, emergency medical technicians and other health professionals. The team reviewed more than 600 studies evaluating the use of technologies such as virtual reality computers, mannequins and training models to teach skills and procedures including surgery, trauma management, obstetrics and team communication. Their conclusions were published Sept. 7 in the Journal of the American Medical Association

Modeling for the Decision Process to Implement an Educational Intervention: An Example of a Central Venous Catheter Insertion Course

Just read a paper regarding “decision analytic model of the theoretical impact of an educational intervention to improve the safety” .  This paper demonstrate a system approach (computer modeling and simulation) for health care institutions to estimate the costs and benefits of  proposed interventions (medical simulation training or others).   There is another paper also found even minimal improvement in hand hygiene compliance could lead to substantial savings for hospital.

How about technology solutions (RFID or other RTLS based solutions) to improve hand hygiene compliance ? Joint Commission Resources just published four leading hospitals using RFID solutions to fight HAIs (healthcare assoicated infections) .  Does HIT solutions more cost effective ?  Researchers  start to evaluate technology solutions for the century-old challenge.   Future Study is need to study how to deliver effective and efficient interventions to improve healthcare delivery.  Peter Pronovost’s paper suggests education might not be the strongest risk-reduction intervention in anesthesia.  Multidisciplinary systems approach to modify the latent risk factors  can enable a  design of  more robust system to reduce human errors and improve patient outcome.

Structure, process or outcome: which contributes most to patients’ overall assessment of #healthcare #quality #ptsafety

Structure, process or outcome: which contributes most to patients’ overall assessment of healthcare quality?  This a very interesting paper from patient perspective.   Professor Donabedian already published related papers in Science in 1978 and JAMA in 1988 and milbank in 1966.  Why it takes so long for healthcare industry to appreciate the importance of structure and process ?

The role and education of doctors in the delivery of health care.

Sir Cyril Chantler said 11 years ago, ‘‘Medicine used to be simple, ineffective and relatively safe. Now it is complex, effective and potentially dangerous”. Today’s healthcare is more effective and complex then 10 years ago. Does healthcare safer then before?

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