Just-in-time Decision Support for Improving and Optimising Professional Practices
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Transcript of Just-in-time Decision Support for Improving and Optimising Professional Practices
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Optimizing the Use of
Hospital Resources through
Real-world, Real-time
Information Systems
Prof. Antoine Geissbühler, MD
Geneva University Hospitals
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Geneva University Hospitals
• 2'200 beds
• 3 campuses, 30 smaller sites
• Primary, secondary and
tertiary care
• 50'000 admissions/year
• 800'000 outpatient visits/year
• 10'000 collaborators
• 1‘500 physicians
• 3'500 nurses
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Meaningful integration in the care
processes
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Integrating information
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Considering today'sserum creatinine level, I recommend that youadjust the dosage of intravenous gentamicinto 80mg every 24 hours(and check its bloodlevel in three days)
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From documentation to coordination
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Collaborative care: clinical pathways
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Shorter feedback loops
Resources
People
Equipment
Space
Processes
Interventions
Medications
Tests
Care
Results
Costs
LOS
Satisfaction
Outcome
Evaluation, feedback
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Shorter feedback loops
Resources
People
Equipment
Space
Processes
Interventions
Medications
Tests
Care
Goals
Results
Costs
LOS
Satisfaction
Outcome
Evaluation, feedback
Variance
% of goals
achieved
Often missed
goals
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From orders to workforce adjustment
Order entry
Split orders intoactivities
Schedule activitiesinto acts
Value the workloadfor each act
Match with resourcesfrom HR system
Adjust team workforce if needed
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From activity to flow modeling
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Connected to the real world of people
and objects
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Real-world, real-time information
Challenges:
• Getting the information at its source, once
• Connecting the various information domains
with semantic consistency
• Shorten feedback loops so that the link
between actions and results is more likely
• Errors are photodegradable → transparency