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| Volume
38 Number 3: >>
Applying,
implementing, assessing and evaluating technology. |
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A
guide to performance management for the Health Information
Manager
Sandra G Leggat p11 [ pdf
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Abstract
This paper provides a summary of human resource management
practices that have been identified as being associated with better
outcomes in performance management. In general, essential practices
include transformational leadership and a coherent program of goal
setting, performance monitoring and feedback. Some Health
Information Managers may feel they require training assistance to
develop the necessary skills in the establishment of meaningful work
performance goals for staff and the provision of useful and timely
feedback. This paper provides useful information to assist Health
Information Managers enhance the performance of their staff.
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Using
ICD-10-AM codes to characterise hospital-acquired complications
Jude L Michel, Hong Son Nghiem and Terri J Jackson p18 [ pdf
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Abstract
This paper describes the limitations of using the International
Statistical Classification of Diseases and Related Health Problems,
Tenth Revision, Australian Modification (ICD-10-AM) to characterise
patient harm in hospitals. Limitations were identified during a
project to use diagnoses flagged by Victorian coders as
hospital-acquired to devise a classification of 144 categories of
hospital acquired diagnoses (the Classification of Hospital Acquired
Diagnoses or CHADx). CHADx is a comprehensive data monitoring system
designed to allow hospitals to monitor their complication rates
month-to-month using a standard method. Difficulties in identifying
a single event from linear sequences of codes due to the absence of
code linkage were the major obstacles to developing the
classification. Obstetric and perinatal episodes also presented
challenges in distinguishing condition onset, that is, whether
conditions were present on admission or arose after formal admission
to hospital. Used in the appropriate way, the CHADx allows hospitals
to identify areas for future patient safety and quality initiatives.
The value of timing information and code linkage should be
recognised in the planning stages of any future electronic systems.
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The
impact of health information technology on the quality of medical
and health care: a systematic review
Aziz Jamal, Kirsten McKenzie and Michele Clark p26 [ pdf
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Abstract
The aim of this study was to systematically review the published
evidence of the impact of health information technology (HIT) or
health information systems (HIS) on the quality of healthcare,
focusing on clinicians’ adherence to evidence-based guidelines and
the corresponding impact this had on patient clinical outcomes. The
review covered the use of health information technologies and
systems in both medical care (i.e. clinical and surgical) and other
areas such as allied health and preventive services. Studies were
included in the review if they examined the impact of Electronic
Health Record (EHR), Computerised Provider Order-Entry (CPOE), or
Decision Support System (DS); and if the primary outcomes of the
studies were focused on the level of compliance with evidence-based
guidelines among clinicians. Measurements considered relevant to the
review were either of changes in clinical processes resulting from a
change of the providers’ behaviour, or of specific patient
outcomes that demonstrated the effectiveness of a particular
treatment given by providers. Of 23 studies included in the current
review, 17 assessed the impact of HIT/HIS on health care
practitioners’ performance. A positive improvement, in relation to
their compliance with evidence-based guidelines, was seen in 14
studies. Studies that included an assessment of patient outcomes,
however, showed insufficient evidence of either clinically or
statistically important improvements. Although the number of studies
reviewed was relatively small, the findings demonstrated consistency
with similar previous reviews of this nature in that wide scale use
of HIT has been shown to increase clinician’s adherence to
guidelines.
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