Fall Risk Assessment Through a Self-Service Terminal in the Outpatient Setting.

Health organizations aim to identify patients with high fall risk in the different attention scenarios in order to provide safety and quality care. In order to address this issue, we designed an assessment tool that surveys fall risk through three questions in self-service terminals in the outpatient setting. Our objectives in this article are to describe the implementation process. A cross sectional design was used for the pilot (between October and November 2018). The issued tickets rate with high fall risk (defined as 2/3 positive responses) was 34.3%. Some adjustments needed to be done because some patients did not have true risk criteria due to self-report. We conclude that this tool will allow quicker identification of patients with true high risk. Effective prevention strategies will be necessary to improve safety after risk fall identification.

Implementation of a clinical decision support system using a service model: results of a feasibility study.

Numerous studies have shown that the quality of health care is inadequate, and healthcare organizations are increasingly turning to clinical decision support systems (CDSS) to address this problem. In implementing CDSS, a highly promising architectural approach is the use of decision support services. However, there are few reported examples of successful implementations of operational CDSS using this approach. Here, we describe how Hospital Italiano de Buenos Aires evaluated the feasibility of using the SEBASTIAN clinical decision support Web service to implement a CDSS integrated with its electronic medical record system. The feasibility study consisted of three stages: first, end-user acceptability testing of the proposed CDSS through focus groups; second, the design and implementation of the system through integration of SEBASTIAN and the authoring of new rules; and finally, validation of system performance and accuracy. Through this study, we found that it is feasible to implement CDSS using a service-based approach. The CDSS is now under evaluation in a randomized controlled trial. The processes and lessons learned from this initiative are discussed.

Computerization of a preanesthetic evaluation and user satisfaction evaluation.

Preanesthetic evaluation purpose is to reduce morbidity and mortality through the review of the patient's medical history, clinical examination, and targeted clinical studies, providing referrals for medical consultations when appropriated. Changes in patient care, standards of health information management and patterns of perioperative care, have resulted in a re-conceptualization of this process where the documentation of patient medical information, the efforts in training and maintaining the integrity of the medical-legal evaluation are areas of concern. The aim of this paper is to describe the design, development, training, and implementation of a computerized preanesthetic evaluation form associated to the evaluation of the user satisfaction with the system. Since the system went live in September 2008 there were 15121 closed structured forms, 60% for ambulatory procedures and 40 % for procedures that required hospital admission. 82% of total closed structured forms had recorded a risk of the procedures of 1-2, according to the American Society of Anesthesiologists classification. The survey indicates a positive general satisfaction of the users with the system.