Datenverarbeitung in der Intensivmedizin

Zusammenfassung

Die Intensivmedizin wie auch das gesamte Gesundheitssystem stehen vor der Herausforderung, eine qualitativ hochwertige Versorgung immer schwerer erkrankter Patienten mit beschränkten Ressourcen sicherzustellen. Diese Herausforderung kann nur durch Standardisierung, kontinuierliches Qualitätsmanagement und Effektivitätssteigerung der Patientenversor­gung erreicht werden. Hierbei nimmt das Management von patientenbezo­genen Daten und Informationen sowie medizinischem Wissen eine zentrale Rolle ein. Moderne Patientendatenma­nagementsysteme werden in Zukunft eine entscheidende Funktion bei diesen Aufgaben haben.

Literatur

• 1 OECD . OECD Health Data 2003: Comparative Analysis of 30 Countries.  OECD. 2003; 
• 2 Kirton O C, Civetta J M, Hudson-Civetta J. Cost effectiveness in the intensive care unit.  Surg Clin North Am. 1999;  76 175-200
• 3 Ridley S, Biggam M, Stone P. A cost-benefit analysis of intensive therapy.  Anaesthesia. 1993;  48 14-19
• 4 Washington, DC:. Committee on Quality of Health Care in America, Institute of Medicine .Crossing the Quality Chasm: A New Health System for the 21st Century. National Academy Press 2001
• 5 Kohn L T, Corrigan J M, Donaldson M. To Err Is Human. Building a Safer Health System. Committee on Quality of Health Care in America. Institute of Medicine Washington, DC; National Academic Press 2000
• 6 Leape L L. Error in medicine.  JAMA. 1994;  272 1851-1857
• 7 Lesar T S, Briceland L, Stein D S. Factors related to errors in medication prescribing.  JAMA. 1997;  277 312-317
• 8 Bates D W, Cullen D J, Laird N. et al . Incidence of adverse drug events and potential adverse drug events. Implica­tions for prevention. ADE Prevention Study Group.  JAMA. 1995;  274 29-34
• 9 Wilson D G, McArtney R G, Newcombe G. Medication Errors in Paediatric Practice: Insights from a Continuous Quality Improvement Approach.  Eur J Pediatr. 1998;  157 769-774
• 10 Ferraris V A, Propp M E. Outcome in critical care patients: a multivariate study.  Crit Care Med. 1992;  20 967-976
• 11 Bracco D, Favre J B, Bissonnette B. et al . Human errors in a multidisciplinary intensive care unit: a 1-year prospective study.  Intensive Care Med. 2001;  27 137-145
• 12 Berenholtz S, Pronovost P, Lipsett P. et al . Assessing the effectiveness of critical pathways on reducing resource utilization in the surgical intensive care unit.  Intensive Care Med. 2001;  27 1029-1036
• 13 Haux R. Aims and tasks of medical informatics.  Int J Med Inf. 1997;  44 9-20
• 14 Gardner R M. Computerized management of intensive care patients.  MD Comput. nnn198nnn;  3 36-51
• 15 Balas E A, Weingarten S, Garb C T. et al . Improving preventive care by prompting physicians.  Arch Intern Med. 2000;  160 301-308
• 16 Gardner R M. Computer technology and its application to cardiovascular nursing.  J Cardiovasc Nurs. 1987;  1 69-71
• 17 Chalmers T C, Laus J. Meta-analytic stimulus for changes in clinical trials.  Stat Methods Med Res. 1993;  2 161-172
• 18 Leyerle B J, LoBue M, Shabot M. Integrated computerized databases for medical data management beyond the bedside.  Int J Clin Monit Comput. 1990;  7 83-89
• 19 Shabott M M, LoBue M, Leyerle B J. et al . Decision support alerts for clinical laboratory and blood gas data.  In J Clin Monit Comput. 1990;  7 27-31
• 20 Fraenkel D J, Cowie M, Daley P. Quality benefits of an intensive care clinical information system.  Crit Care Med. 2003;  31 120-125
• 21 Abramson N S, Wald K S, Grenvik A N. et al . Adverse occurrences in intensive care units.  JAMA. 1980;  244 1582-1584
• 22 Morris A H. Computerized protocols and beside decision support.  Crit Care Clin. 1999;  15 523-545
• 23 Wu A W, Folkman S, McPhee S J. et al . Do house officers learn from their mistakes?.  JAMA. 1991;  265 2089-2094
• 24 Cook R, Woods D. Operating at the Sharp End: the Complexity of Human Error. Bogner MS Human Errors in Medicine Hillsdale, NJ; Lawrence Erlbaum Associates 1994: 255-310
• 25 Cook R, Woods D Miller C. A Tale of Two Stories: Contrasting Views of Patient Safety. Chicago, IL; National Patient Safety Foundation 1998
• 26 Cook D. Evidence-based critical care medicine. A potential tool for change.  New Horizons. 1998;  6 20-25
• 27 Grimm R H Jr, Shimoni K, Harlan W R Jr. et al . Evaluation of patient-care protocol use by various providers.  N Engl J Med. 1975;  292 507-511
• 28 Grimshaw J M, Russell I T. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations.  Lancet. 1993;  342 1317-1322
• 29 Shewart W. Economic control of quality of manufactured product. New York, NY; D. Van Nostrand 1931
• 30 Walton M. The Deming management method. New York, NY; Putnam 1986
• 31 Classen D C, Evans R S, Pestotnik S L. et al . The timing of prophylactic administra­tion of antibiotics and the risk of surgical-wound infection.  N Engl J Med. 1992;  326 281-286
• 32 Classen D C, Pestotnik S L, Evans R S. et al . Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality.  JAMA. 1997;  277 301-306
• 33 East T. Role of the computer in the delivery of mechanical ventilation. Tobin M Principles and Practice of Mechanical Ventilation New York, NY; MacGraw-Hill 1994: 1005-1038
• 34 Johnston M E, Langton K B, Haynes R B. et al . Effects of computer-based clinical decision support systems on clinician performance and patient outcome. A critical appraisal of research.  Ann Intern Med. 1994;  120 135-142
• 35 Pestotnik S L, Classen D C, Evans R S. et al . Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes.  Ann Intern Med. 1996;  124 884-890
• 36 Wirtschafter D D, Scalise M, Henke C. et al . Do information systems improve the quality of clinical research? Results of a randomized trial in a cooperative multi-institutional cancer group.  Comput Biomed Res. 1981;  14 78-90
• 37 Morris A H. Algorithm-Based Decision-Making. Tobin JA Principles and Practice of Intensive Care Monitoring New York, NY; McGraw-Hill 1998: 1355-1381
• 38 Hunt D L, Haynes R B, Hanna S E. et al . Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systema- <! leerstelle entfernen>tic review.  JAMA. 1998;  280 1339-1346
• 39 Bates D W, Teich J M, Lee J. et al . The impact of computerized physician order entry on medication error prevention.  J Am Med Inform Assoc. 1999;  6 313-321
• 40 McDonald C J. Protocol-based computer reminders, the quality of care and the non-perfectability of man.  N Engl J Med. 1976;  295 1351-1355
• 41 McDonald C J, Wilson G A, McCabe G P Jr. Physician response to computer reminders.  JAMA. 1980;  244 1579-1581
• 42 Teich J M, Glaser J P, Beckley R F. et al . The Brigham integrated computing system (BICS): advanced clinical systems in an academic hospital environment.  Int J Med Inf. 1999;  54 197-208
• 43 Bates D W, Spell N, Cullen D J. et al . The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group.  JAMA. 1997;  277 307-311
• 44 Gebhart F. VA Facility Slashes Drug Errors Via Bar-coding.  Drug Topics. 1999;  1 44
• 45 Imhoff M. How to measure return on investment.  Care of the critically ill. 2001;  17 198-204
• 46 Imhoff M. Clinical pathways as a tool for „intelligent” rationing in intensive care. Vincent JL Yearbook of intensive care and emergency medicine 2000 Heidelberg; Springer 2000: 781-792
• 47 Sharpe V, Faden A. Medical Harm. Cambridge, UK; Cambridge University Press 1998
• 48 Friedman C P, Elstein A S, Wolf F M. et al . Enhancement of clinicians’ diagnostic reasoning by computer-based consultation: a multisite study of 2 systems.  JAMA. 1999;  282 1851-1856
• 49 Kassirer J P. A report card on computer-assisted diagnosis-the grade: C.  N Engl J Med. 1994;  330 1824-1825
• 50 Imhoff M, Webb A, Goldschmidt A. et al . Health Informatics.  Intensive Care Med. 2001;  27 179-186