How Structured Templates Increase Emergency Department Efficiency (in 68 Seconds)

Structured charting helps emergency physicians practice faster, safer medicine.

How Evidence-based documentation helps patient-based funding

How BEC Clinical Content Supports QBPs

Quality-based procedures (QBPs) are clusters of patient groups that have been identified by the Government of Ontario as offering an opportunity for care improvement and cost reduction.  Patient-based funding in Ontario is now partially based on QBP performance.  The move toward a patient-centred, evidence-informed funding model requires significant changes in how care is documented and
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How to get clinical decision support

Four Paths to Clinical Decision Support

Clinical content and clinical decision support turn an EHR from an empty electronic shell into an effective tool for clinicians.  Canada Health Infoway says that “the greatest value to future EHR functionality will come via clinical decision support and will change the way in which we think about care delivery”. According to the U.S. Office of
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Algonquin's healthcare simulator in action

Training with dummies at Algonquin College

Last night Algonquin College, in conjunction with CapCHI – a user interface group, hosted a demonstration of Algonquin’s healthcare simulator.  Algonquin uses the simulator to train nurses, respiratory therapists, and other health professionals. The lab they use is set up as a generic hospital ward and is similar to that used for training in many places.  What made
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Paper vs EHR documentation time

What to do when you spend more time with your EHR than with your patients

The recent AJEM article 4000 Clicks: a productivity analysis of electronic medical records in a community hospital ED has gotten a fair bit of attention, and rightly so.  The article points out several troubling facts for EDs that have adopted EHRs or that are considering doing so: 43% of physicians’ time spent on data entry 28% of time in
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Risks and drawbacks of EDISs

What we don’t hear: the risks associated with EDIS

“Electronic health records, including EDISs, should be designed to match common properties of human perception and decisionmaking, as well as task- and use-specific properties of work.” – Farley et al. The Quality Improvement and Patient Safety Section and the Informatics Section of the American College of Emergency Physicians recently published an article in the Annals of Emergency Medicine about the
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Sometimes knowledge translation doesn't happen

Knowledge Translation in the ED: How to Get Evidence Used

The modern mantra of medicine is that assessments and interventions should be evidence-based.  This means that new research should be incorporated into practice, and interventions that have not been demonstrated to work should be avoided. There are very few physicians who would dispute this.  However, with the volume of preclinical to clinical articles published every
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A model for successful change in the ED

Change in the ED. Are you asking the right questions?

Congratulations!  You’ve decided you want to bring about change in your healthcare organization.  You’re going to bring in an EMR, add some knowledge transfer tools, change workflow, or bring in a new coffee maker.  It could be anything! Here’s the problem: No matter how big or small the change, you can expect resistance.  But you
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Why docs use EHRs

How to make your EHR better

Doctors aren’t happy with their EHRs.  That’s the conclusion of a recent RAND report  (and brought to my attention by Dr. David More’s blog. The study identifies several complaints about EHRs from the perspective of doctors who use them.  According to the report, doctors perceive EHRs as hindering their ability to provide quality care, because: Using computers interferes
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costs of developing clinical content

How much will it cost to develop our own clinical content?

In Brief: The costs of developing clinical content internally are high – almost $2 million for the most basic (but useful) content.  However, the real impediment to building advanced clinical decision support is the complexity of the project and maintaining such a system. The Details Clinical content is invaluable in any emergency department where increasing
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