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The Five Rights of
Effective Clinical Informatics
Implementation
Right Outcomes
Where
to begin planning to deliver Effective Patient Care? Start with the
identification of problems, that if solved, would strongly benefit
patients and their caregivers using methods discussed for building the Right
Consensus. Then, pick metrics to quantify the desired outcomes. You probably have a sense of where the
issues are, but quantify them!
First,
you may find that some issues are worse than you thought, leading to a
re-focusing of your efforts. Second, numbers are inherently more
persuasive than words in enlisting supporters. Thirdly, these numbers
serve as the baseline for measuring the success of the efforts.
Ultimately,
the only criterion for success is whether patient care became more
effective. Often, we base this on opinions, casually gathered, rather
than substantive, rigorously collected data. Data
gathering and analysis can seem superfluous, but measurement of outcomes
is an
essential method to recognize which areas need further improvement
Measure
clinical outcomes of aggregate processes
The
most compelling data are the clinical outcomes. Indeed, consumers are
most interested in the big picture--do patients get better--far more
than the details that they would like to assume are always flawlessly
executed.
Measure
effectiveness of sub-processes of clinical operations
While
the desired measure of success is what happened to the patient, that
complex outcome can be influenced by so many factors it can be hard to
know what was responsible for the outcome. By breaking the patient care
process into smaller steps and measuring the defect rate of the
sub-process, the impact on the overall process can be inferred. For
example, if patients get their medications late or not at all, it is not
a large leap to anticipate an unfavorable outcome. Or, if the wrong
medication is used, it is not necessary to have a large enough sample
size to demonstrate bad outcomes to know that changes are needed.
Measure
computer system
utilization
When
computer-based systems are implemented, it is often assumed that they are being used
for their intended purposes. However, this is
often not the case. Utilization varies by individual user, by patient
care area, by different disease types. Each variation might identify a
special need for different reports, processes, or training.
Track
financial metrics
There
is never enough money to do everything an institution would like to do.
For that reason, stewardship of scarce resources, the financial benefits
of system changes must be measured and understood. Such metrics should
be designed into the implementation of changes. Effective patient care
means better clinical outcomes, but also within the reality of financial
constraints.
Understanding the desired outcomes leads you to the
Right Clinical Data.
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