Evidence-based health care management: what is the research evidence available for health care managers?

In light of increasing interest in evidence-based management, we conducted a scoping review of systematic reviews (SRs) and meta-analyses (MAs) to determine the availability and accessibility of evidence for health care managers; 14 MAs and 61 SRs met the inclusion criteria. Most reviews appeared in medical journals (53%), originated in the United States (29%) or United Kingdom (22%), were hospital-based (55%), and targeted clinical providers (55%). Topics included health services organization (34%), quality/patient safety (17%), information technology (15%), organization/workplace management (13%), and health care workforce (12%).

CAH staff perceptions of a clinical information system implementation.

Objectives: This study examines staff perceptions of patient care quality and the processes before and after implementation of a comprehensive clinical information system (CIS) in critical access hospitals (CAHs).

Study Design: A prospective, nonexperimental design, evaluation study.

Methods: A modified version of the Information Systems Expectations and Experiences (I-SEE) survey instrument was administered to staff in 7 CAHs annually over 3 years to capture baseline, readiness, and postimplementation perceptions.

Nurses' perceptions of how clinical information system implementation affects workflow and patient care.

There is a little evidence of the impact of clinical information system implementation on nurses' workflow and patient care to guide institutions across the nation as they implement electronic health records. This study compared changes in nurse's perceptions about patient care processes and workflow before and after a comprehensive clinical information system implementation at a rural referral hospital. The study used the Information Systems Expectations and Experiences survey, which consists of seven scales-provider-patient communication, interprovider communication, interorganizational communication, work-life changes, improved care, support and resources, and patient care processes.

Patient safety outcomes in small urban and small rural hospitals.

Purpose: To assess patient safety outcomes in small urban and small rural hospitals and to examine the relationship of hospital and patient factors to patient safety outcomes.

Methods: The Nationwide Inpatient Sample and American Hospital Association annual survey data were used for analyses. To increase comparability, the study sample was restricted to hospitals with fewer than 100 beds.

Transformation of Emergency Department processes of care with EHR, CPOE, and ER event tracking systems.

Mercy Medical Center, North Iowa implemented electronic health records (EHR), computerised provider order entry (CPOE) and event tracking systems in the emergency department (ED) as part of hospital-wide implementation of clinical information systems. This case study examines the changes in outcomes and processes in the ED following implementation. Although the system was designed to enhance efficiency, there was a significant increase in the mean length of stay (about 17 minutes, or 15%) in the ED after implementation.

Do postoperative complications vary by hospital teaching status?

Objective: The purpose of this paper is to assess postoperative patient safety outcomes across teaching and nonteaching hospitals and to examine the relation of hospital and patient factors to patient safety outcomes.

Research Design And Methods: The Nationwide Inpatient Sample and American Hospital Association annual survey data were used for analyses. Patient safety indicators (PSIs) developed by the Agency for Healthcare Research and Quality (AHRQ) were used to identify 6 postoperative PSIs.

Clinical information system availability and use in urban and rural hospitals.

Clinical information systems (CIS) capture clinical data to support more efficient and effective decision making and clinical care delivery. Only a few estimates of CIS availability and use in hospitals are available nationally. The purpose of the current research is to examine differences in CIS availability and use between urban and rural hospitals.