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KMID : 0385920090200060689
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Journal of the Korean Society of Emergency Medicine
2009 Volume.20 No. 6 p.689 ~ p.696
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The Efficacy of a Critical Event Monitoring System for Critical Care
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Woo Jae-Hyuk
Lim Yong-Su
Kim Jae-Kwang
Kim Jin-Joo
Hyun Sung-Youl
Yang Hyuk-Jun
Lee Keun
Lee Mi-Jin
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Abstract
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Purpose: This study evaluated the efficacy and positive influences of a critical event monitoring system (CEMS), which is an automatic alerting system for patients with critical laboratory results.
Methods: We compared various patient data variables with hyperkalemia during the 1 year before and after CEMS, which was initiated in July 2007 (Before group: July 2006~June 2007, After group: July 2007~June 2008).
Results: A total of 2,417 patients had severe hyperkalemia (K+≥6.5 mmol/L) during the period. Of the 2,417, 1680 were excluded, Leaving 389 patients to be enrolled in the ‘before group’ and 348 in the ‘after group’. Baseline characteristics were similar between the two groups. Although the load of work for the medical staff increased during the period when CEMS was begun, the time interval from critical laboratory results to appropriate treatment decreased (72.68±94.03 vs. 70.07±92.28 minutes) as did the length of hospital stays (20.27±27.01 vs. 17.03±26.89 days). These decreases were not statistically significant. Decreases in time interval and hospital stay were more prominent for patients treated in the ICU and by emergency physicians during the day time. Mortality within 48 hours (19.5 vs. 19.5%) did not change after beginning CEMS. Mortality in the ICU (2.04 vs. 1.94%, p=0.046) decreased after beginning CEMS.
Conclusion: Information technology strategies such as using CEMS may be an effective tool for improving the quality of medical care. But we must also consider other factors such as work load of the medical staff which also influence the quality of medical care.
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KEYWORD
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Quality of health care, Clinical laboratory information systems, Critical care
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