Potential identifiability and preventability of adverse events using information systems. Export

@article{citeulike:239377, abstract = {STUDY OBJECTIVE: To evaluate the potential ability of computerized information systems (ISs) to identify and prevent adverse events in medical patients. DESIGN: Clinical descriptions of all 133 adverse events identified through chart review for a cohort of 3,138 medical patients were evaluated by two reviewers. MEASUREMENTS: For each adverse event, three hierarchical levels of IS sophistication were considered: Level 1--demographics, results for all diagnostic tests, and current medications would be available on-line; Level 2--all orders would be entered on-line by physicians; and Level 3--additional clinical data, such as automated problem lists, would be available on-line. Potential for event identification and potential for event prevention were scored by each reviewer according to two distinct sets of event monitors. RESULTS: Of all the adverse events, 53\% were judged identifiable using Level 1 information, 58\% were judged identifiable using Level 2 information, and 89\% were judged identifiable using Level 3 information. The highest-yield event monitors for identifying adverse events were "panic" laboratory results, unexpected transfer to an intensive care unit, and hospital-incurred trauma. With information from Levels 1, 2, and 3, 5\%, 13\%, and 23\% of the adverse events, respectively, were judged preventable. For preventing these adverse events, guided-dose algorithms, drug-laboratory checks, and drug-patient characteristic checks held the most potential.}, address = {Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.}, author = {Bates, D. W. and O'Neil, A. C. and Boyle, D. and Teich, J. and Chertow, G. M. and Komaroff, A. L. and Brennan, T. A.}, citeulike-article-id = {239377}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/7850564}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=7850564}, issn = {1067-5027}, journal = {J Am Med Inform Assoc}, keywords = {adverse-events, information-systems, medicine}, number = {5}, pages = {404--411}, posted-at = {2005-06-28 08:28:49}, priority = {3}, title = {Potential identifiability and preventability of adverse events using information systems.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/7850564}, volume = {1}, year = {1994} }

TY - JOUR ID - citeulike:239377 L3 - citeulike-article-id:239377 N2 - STUDY OBJECTIVE: To evaluate the potential ability of computerized information systems (ISs) to identify and prevent adverse events in medical patients. DESIGN: Clinical descriptions of all 133 adverse events identified through chart review for a cohort of 3,138 medical patients were evaluated by two reviewers. MEASUREMENTS: For each adverse event, three hierarchical levels of IS sophistication were considered: Level 1--demographics, results for all diagnostic tests, and current medications would be available on-line; Level 2--all orders would be entered on-line by physicians; and Level 3--additional clinical data, such as automated problem lists, would be available on-line. Potential for event identification and potential for event prevention were scored by each reviewer according to two distinct sets of event monitors. RESULTS: Of all the adverse events, 53% were judged identifiable using Level 1 information, 58% were judged identifiable using Level 2 information, and 89% were judged identifiable using Level 3 information. The highest-yield event monitors for identifying adverse events were "panic" laboratory results, unexpected transfer to an intensive care unit, and hospital-incurred trauma. With information from Levels 1, 2, and 3, 5%, 13%, and 23% of the adverse events, respectively, were judged preventable. For preventing these adverse events, guided-dose algorithms, drug-laboratory checks, and drug-patient characteristic checks held the most potential. IS - 5 JF - J Am Med Inform Assoc SN - 1067-5027 AD - Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115. EP - 411 TI - Potential identifiability and preventability of adverse events using information systems. VL - 1 SP - 404 KW - adverse-events KW - information-systems KW - medicine AU - Bates, DW AU - O'Neil, AC AU - Boyle, D AU - Teich, J AU - Chertow, GM AU - Komaroff, AL AU - Brennan, TA PY - 1994///t UR - http://view.ncbi.nlm.nih.gov/pubmed/7850564 ER -