just-in-time decision support for improving and optimising professional practices
Post on 05-Dec-2014
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Optimizing the Use of
Hospital Resources through
Real-world, Real-time
Information Systems
Prof. Antoine Geissbühler, MD
Geneva University Hospitals
Geneva University Hospitals
• 2'200 beds
• 3 campuses, 30 smaller sites
• Primary, secondary and
tertiary care
• 50'000 admissions/year
• 800'000 outpatient visits/year
• 10'000 collaborators
• 1‘500 physicians
• 3'500 nurses
Meaningful integration in the care
processes
Integrating information
Considering today'sserum creatinine level, I recommend that youadjust the dosage of intravenous gentamicinto 80mg every 24 hours(and check its bloodlevel in three days)
From documentation to coordination
Collaborative care: clinical pathways
Shorter feedback loops
Resources
People
Equipment
Space
Processes
Interventions
Medications
Tests
Care
Results
Costs
LOS
Satisfaction
Outcome
Evaluation, feedback
Shorter feedback loops
Resources
People
Equipment
Space
Processes
Interventions
Medications
Tests
Care
Goals
Results
Costs
LOS
Satisfaction
Outcome
Evaluation, feedback
Variance
% of goals
achieved
Often missed
goals
From orders to workforce adjustment
Order entry
Split orders intoactivities
Schedule activitiesinto acts
Value the workloadfor each act
Match with resourcesfrom HR system
Adjust team workforce if needed
From activity to flow modeling
Connected to the real world of people
and objects
Real-world, real-time information
Challenges:
• Getting the information at its source, once
• Connecting the various information domains
with semantic consistency
• Shorten feedback loops so that the link
between actions and results is more likely
• Errors are photodegradable → transparency
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