Localized Prostate Cancer Patients’ Information in Urology Outpatient Practice—Results of a Nationwide Prospective Study in Germany

Purpose: Many studies demonstrate the importance of an empathic communication with prostate cancer patients and show various information needs. Most of the studies are cross sectional. The present analysis aims to 1) provide detailed prospective data on the actual quality of patient information provided by urologists in private practice in Germany;and 2) explore sociodemographic, communicative, and health- and treatment related determinants of the quality of provider-patient-communication. Methods: HAROW is a prospective, observational study designed to collect clinical data and patient reported outcomes of different treatment options (hormonal therapy, active surveillance, radiation, operation, watchful waiting) for newly diagnosed patients with localized prostate cancer under real conditions. At 6-month intervals, general clinical data, patient reported outcomes and patients’ assessment of patient-physician-communication are documented. A total of 1893 questionnaires at t0 (initial diagnosis) and t1 (six months after diagnosis) were analyzed. A linear regression model was estimated. Results: The mean age of the men was 68.38 years, and most lived with their spouse or partner (94.1%). Most patients were informed about treatment options (t0 96%, t1 93.2%), but much fewer received information about self-help groups (t0 36.4%, t1 45.8%), rehabilitation (t0 59.9%, t1 68%), and second medical opinion (t0 57.2%, t1 59.3%). Older men (p = 0.02) and men living alone (p = 0.048) received less information than others. Physician empathy (p = 0.000) and prostatectomy treatment (p = 0.020) were positively associated with receiving more information. Conclusion: There is room for improvement in terms of informing prostate cancer patients about rehabilitation, second medical opinion and self-help groups. Urologists being empathetic share more information with their patients. Some patients receive less information than others, especially older patients living alone.

A Review of Index Case Testing Induced Intimate Partner Violence and Electronic Management of Information in HIV Care

Intimate Partner Violence (IPV) is a form of Gender Base Violence (GBV) where an intimate partner perpetrates violence. In the HIV care continua which has the aim of achieving epidemic control based on the goals defined by UNAIDS, 95% of people living with HIV (PLHIV) have to know their HIV status, 95% initiated ARV treatment and 95% are virally suppressed in order to achieve epidemic control. One of the evidence-based strategies used for achieving an optimal number of PLHIV who know their HIV status is the Index Case Testing Strategy (ICT). While the ICT strategy helps the achievement of epidemic control, its implementation increases the incidence of IPV among either serodiscordant or concordant couples. Tackling information about IPV is very sensitive. A review of the literature on the management of HIV patient information has shown that shifting from paper-based management of HIV patient information to computerized Electronic Medical Records (EMR) systems, using software such as OPEN MRS has significantly improved the management of HIV patient information with high-level confidentiality of patient information. The reviews showed that the EMR systems put in place to manage HIV patient information need to integrate the stages used for the management of IPV among PLHIV.

Lack of Consensus and Dense Content in Informational Letters on Benign Gynecological Surgery

Objective: This study maps the contents of departmental informational letters and explores whether the national GynOp letters live up to the patients’ expectations and needs. Introduction: Patients who are well informed before undergoing surgery experience reduced stress and increased understanding of the postoperative process. Although providing patients with written information before gynecological surgery is widely used and assumed important, no study has investigated what information patients truly need. Methods: In 2014, all 59 gynecological departments in Sweden were asked to provide the information letter they send to patients before hysterectomy on benign indication. 32 letters were analyzed using frequency analysis. In addition, three focus groups were conducted and these data were submitted to Qualitative Content Analysis. Results: The analysis of the information letters showed great variation and discrepancy in pre-operative information. The analysis of the focus groups resulted in the theme You can’t see the forest for the trees, reflecting that, the women found it very difficult to identify the most important information among the massive amount information received. Conclusions: The informational letters did not meet the patients’ expectations and needs. Practice implications: This study could serve as a foundation for the content of informational letters.

Inflammatory bowel disease: An evaluation of health information on the internet

To evaluate the quality and accuracy of websites written to the public on inflammatory bowel disease (IBD) (Crohn’s disease and ulcerative colitis) and assess their readability level.METHODSGoogle™, Bing™, and Yahoo™ search engines were searched independently by three researchers in December 2014. Only English-language websites were selected on the basis of predetermined inclusion and exclusion criteria. Researchers independently evaluated the quality of each website by using the DISCERN and the HONcode instruments. The readability levels were calculated using two formulas; the Flesch-Kincaid Grade Level Index, and the Coleman-Liau Readability Index. The agreement between the evaluators was calculated using Cohen kappa coefficient.RESULTSEighty-four websites were finally identified. Scores varied from a minimum DISCERN score of 18 to a maximum of 68 [mean ± SD, 42.2 ± 10.7; median = 41.5, interquartile range, interquartile range (IQR) = 15.8] and a minimum score of HONcode of 0.14 and a maximum of 0.95 (mean ± SD, 0.16 ± 0.19; median = 0.45, IQR = 0.29). Most of these websites were reviewed in 2014 and 2015 (n = 51). The creators of these websites were: universities and research centers (n = 25, 30%), foundations and associations (n = 15, 18%), commercial and pharmaceutical companies (n = 25, 30%), charities and volunteer work (n = 9, 10%), and non-university educational bodies (n = 10, 12%). The Flesch-Kincaid Grade Level readability score (mean ± SD) was 11.9 ± 2.4 and the Coleman-Liau Readability Index score was 12.6 ± 1.5. Significant correlation was found between the two readability scores (R2 = 0.509, P = 0.001). The overall agreement between evaluators measured by Cohen kappa coefficient was in the range of 0.804-0.876; rated as 'Good'.CONCLUSIONThe DISCERN and the HONcode scores of websites varied and the readability levels of most websites were above the public readability level. The study highlights the areas that need further improvement and development in patient education online materials about IBD.

基于临床需求的重症医学临床信息系统设计与应用

目的针对急诊重症患者临床管理需求,构建重症医学临床信息系统,并对其临床应用效果进行评价。方法系统以临床需求为导向,采用面向服务架构设计,服务端和客户端之间松耦合,并采用有线无线深度融合的网络架构,实现了多系统信息共享、病情数据自动采集记录和信息可视化等功能。选择系统应用前后各100例患者的病历资料对系统应用效果进行分析评价。结果重症医学临床信息系统应用后,各类医疗文书处理耗时和患者ICU入住时长均显著缩短(P<0.05);医护人员满意度显著提升(P<0.05)。结论基于临床需求构建的重症医学临床信息系统可提高临床管理效率,对提升临床管理和治疗质量有积极意义;系统的开发与应用也为各类医疗信息系统的建设工作提供了参考。

出院患者回访管理系统的设计与应用

随着医疗信息技术的快速发展,出院患者回访管理系统成为提高医疗服务质量和优化患者关怀措施的重要工具。该研究从医院信息化角度出发,详细介绍了出院患者回访管理系统的设计原则、技术实现及应用效果。系统采用C#的.NET框架,使用SQL Server数据库实现前后端互通,具备患者信息识别和标记功能、回访内容自动生成功能和数据报告生成功能。实际应用效果显示,出院患者回访管理系统具有界面显示直观、操作友好的特点,可提高患者回访配合度及医护人员满意度、缩短回访时间,回访数据可用于改进医疗服务质量、优化人员配置。

医院信息管理系统对改善医患关系的影响

医院信息管理系统在改善医患关系方面发挥着重要作用。本文分析了该系统对医患关系的影响,主要包括:优化就医流程,提高患者满意度;加强医患沟通,增进相互理解;降低医疗风险,提升医疗质量;提高服务透明度,减少误解纠纷。研究发现,医院信息管理系统通过整合医疗资源,实现患者信息数字化管理,简化就医流程,提供便捷沟通渠道,有效改善了医患关系,提高了医疗服务质量和患者满意度。

门诊信息化和医疗服务保障体系联合应用效果分析

目的探讨门诊信息化和医疗服务保障体系在提升门诊优质服务水平中的作用。方法总结1年多来门诊信息化建设和医疗服务保障体系在提升门诊医疗服务水平中的经验。结果门诊信息化为医院门诊医疗服务提供了高效的作业工具,提高了就诊效率;SAFE-CARE体系保障了医疗安全和医疗质量,提升了医院管理水平。结论门诊信息化和SAFE-CARE体系式联合应用是解决群众"看病难和看好病"的重要举措。

医院门诊医生站的建设体会

门诊医生站是门诊信息系统的核心环节,因其业务本身的复杂性,使得建设和实施上更具难度和挑战。本文阐述了我院实施门诊医生站的具体做法,希望对同行有所帮助。

医院门诊管理数据仓库的设计和实现

针对医院信息系统发展现状,对于日常工作中积累的数据,只能进行一些简单的财务或报表统计,而大量数据统计会对基于OLAP技术的医院信息系统性能产生严重影响。因此根据门诊管理需求,对医院2004年到2008年的门诊数据进行了全面分析,确定了门诊管理主题,并逐步将医院信息管理系统中的数据,通过抽取、清洗、转换并加载到门诊数据仓库中。通过使用OLAP技术提供大量门诊管理需用的分析报表,满足了门诊管理部门的统计分析需求。

医院信息化在新冠肺炎防控中的应用实践探索

新型冠状病毒肺炎疫情的蔓延给社会生活和经济带来巨大影响,为做好疫情防控工作,医院通过使用二维码预检分诊,嵌入HIS系统疫区人员信息,全方位开展“互联网+医疗服务”,依托钉钉平台开展培训考核、员工健康信息监测以及院内就诊、检查、检验信息的互联互通,充分发挥了信息化的支撑作用,成功实现院内“零死亡、零感染”目标,为今后应对突发重大传染病事件提供了应对思路。

节点信息化精准管控在手术患者转运交接中的应用效果

目的探讨利用个人数字助理(personal digital assistant,PDA)进行节点信息化精准管控在手术患者转运交接中的应用效果。方法采用历史对照研究,将2019年1-6月收治的11219例手术患者作为对照组,将2019年7-12月收治的11931例手术患者作为观察组,对照组采用纸质版转运交接单进行患者转运交接,观察组采用PDA行节点信息化精准管控方式进行患者转运交接。比较2组患者转运交接单填写规范率、转运交接类不良事件发生率、手术患者转运交接单准备时间。结果观察组转运交接单填写规范率明显高于对照组(χ^(2)=193.574,P<0.001);转运过程中不良事件发生率明显低于对照组(χ^(2)=216.736,P<0.001);手术患者转运交接单准备时间明显短于对照组(t=457.923,P<0.001)。结论运用PDA行节点信息化管控,能有效提升手术患者转运交接单书写规范率,降低转运过程中不良事件的发生率,缩短转运交接准备时间,有效提高交接效率,保证患者安全。

老年居家置管患者置管优化管理信息化模式的探讨

目的探讨老年居家置管患者置管优化管理信息化模式的临床应用效果。方法 2016年11月至2017年4月,便利抽样选择符合条件的患者44例作为研究对象,按单双号分为观察组和对照组各22例。观察组采用置管优化管理信息化模式,对照组采用常规康复护理指导、出院宣教以及家庭随访、门诊复查等。评价并比较两组患者的并发症、置管意外的发生情况及干预前后Karnofsky预后功能评定、日常生活能力。结果观察组患者并发症、置管意外的发生情况均低于对照组,差异均有统计学意义(P<0.05)。两组Karnofsky预后功能、日常生活能力评分比较,干预前,差异均无统计学意义(P>0.05);干预后,观察组Karnofsky预后功能、日常生活能力高于对照组,差异均有统计学意义(P<0.05)。结论采用置管优化管理信息化模式,可以使老年居家置管患者并发症及意外的发生率降低,提升其生活质量和日常生活能力。

Reading Levels of Leaflets of Common Over-the-Counter Drugs in Ghana

Health communication is critical component of effective health delivery. While there are studies on the readability Patient Information Leaflets (PILs) around the world, so far, there is only one Ghanaian study that explored the language of patient information leaflets for malaria. The present study explores the language of PILs of seven common ailments in Ghana. In all, 68 leaflets were purposely sampled for the study. Using SMOG and Flesch Kincaid grade level readability formulae, the researcher measured the readability of PILs and discovered that the readability of all the PILs was difficult to read except the dewormer leaflets that scored standard reading score. Further statistical analysis reveal that the lexical and syntactic complexity of the leaflets were not statistically different. Finally, an interview with 20 patients confirmed that the leaflets are difficult to read due to the complex words and long sentence structures. It is recommended that the PILs be revised to make the leaflets readable.

信息化抢单模式在手术患者身份识别及交接环节中的应用

目的探讨信息化抢单模式在手术患者交接环节中的应用效果。方法在医院信息系统基础上开发并使用手术患者身份识别信息及转运抢单系统,应用于手术患者交接转运环节,通过信息化抢单模式进行患者术前的转运工作,扫描手术患者信息条码通知单及患者腕带上的二维码实现手术患者转运交接及患者入手术室核对,病区与手术室护士通过信息系统共享手术患者的相关信息完成身份识别。将使用信息化抢单模式系统前(2017年7月1日-2018年6月30日)的择期手术作为对照组,使用信息化抢单模式系统后(2018年7月1日-2019年6月30日)的择期手术作为观察组;比较使用信息化抢单模式系统前后的交接失误率及使用者满意度。结果信息化抢单模式系统在临床应用以来降低了手术患者身份错误的发生,失误率由0.23%降低到0.03%(χ^(2)=21.018,P<0.01)。并且提高了信息化转运使用者的便捷度,术间护士的满意度由33%提升到71.6%(χ^(2)=28.953,P<0.01),运送人员满意率由15.4%提升到84.6%(χ^(2)=15.231,P<0.01)。结论信息系统应用于手术患者交接,保证手术患者身份识别的准确性及交接安全,值得推广。

基于信息系统平台的门诊流程优化研究

优化门诊流程是以病人为中心,在现有流程的基础上,充分利用信息技术手段,通过使用一卡通对门诊业务流程进行重新规划与设计,以达到改善成本、质量、服务和效率的目的。通过探讨一卡通改善门诊就医流程的途径和方法,经多实践验证,显著提高了工作效率、病人满意度等,加强了和谐医患关系。

基于多学科联合管理体系的信息化危急值闭环管理

目的加强临床危急值信息化闭环管理,以缩短危急值处置周期,提高临床危急值处置效率及质量。方法对临床危急值进行多学科联合的信息化闭环管理,即建立危急值闭环管理系统,优化危急值管理系统功能,加强危急值报告监控。统计并比较2015年7~12月(闭环管理前)、2016年7~12月(闭环管理后)检验结果危急值延迟应答情况。结果 2015年7~12月危急值上报总数3 638例次,延迟应答245例次,2016年7~12月危急值上报总数3 302例次,延迟应答43例次,管理前后危急值应答延迟率比较,差异有统计学意义(P<0.01)。结论对临床危急值进行信息化闭环管理,可降低危急值延迟应答率,提高患者安全与护理质量。

伦理视域下医疗信息化问题研究

在医疗信息化带来了信息流动性和交互性增强的益处的同时,其在客观上也带来了医患关系冷漠、隐私信息泄露的问题。因此,保证信息数据真实有效是信息化发展的基础。而利用信息化节约时间、方便交流的优势改善医患关系,通过信息监管、加密的方法保护患者隐私和建立数据质量标准的解决方案是医疗信息化科学安全发展的的重要措施。

上海市级医院患者满意度信息化测评方式运用现状分析

患者满意度是衡量现代医院管理和服务水平的经典指标。随着医院信息化建设的不断发展,信息化的满意度测评方式备受关注。通过对上海14所市级医院的患者满意度信息化测评实施方法、测评规模和测评结果进行调查研究和数据分析,认为当前不断创新的信息化测评方式已成为患者满意度的主导测评工具,但门诊部分的患者满意度信息化测评规模有待进一步扩大。同时,运用信息化测评方式的患者满意度结果更客观。最后,从优化信息化测评方式、强化信息化测评覆盖面和深化信息化测评结果应用3个方面提出推进患者满意度信息化发展的对策建议。

以患者为中心 建设信息化示范医院

随着信息化的快速发展,医院信息化发展迫在眉睫。要想在有限的医疗资源中占有一席之地,必须加强医院信息化建设,提升医院的软实力。医院2014年信息化系统建设实施方案,详细介绍门诊业务流程及住院业务流程,最后总结医院信息系统在建设运行中出现的问题及解决办法。