Rubber stamp templates for improving clinical documentation: a paper-based, m-Health approach for quality improvement in low-resource settings
Background - The United Nations’ Sustainable Development Goal #3.8 targets ‘access to quality essential healthcare services’. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use o...
Gespeichert in:
| Hauptverfasser: | , , , , , , |
|---|---|
| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
June 2018
|
| In: |
International journal of medical informatics
Year: 2018, Jahrgang: 114, Pages: 121-129 |
| ISSN: | 1872-8243 |
| DOI: | 10.1016/j.ijmedinf.2017.10.014 |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1016/j.ijmedinf.2017.10.014 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S1386505617303775 
|
| Verfasserangaben: | Bernadette Kleczka, Anita Musiega, Grace Rabut, Phoebe Wekesa, Paul Mwaniki, Michael Marx, Pratap Kumar |
MARC
| LEADER | 00000caa a2200000 c 4500 | ||
|---|---|---|---|
| 001 | 1582185220 | ||
| 003 | DE-627 | ||
| 005 | 20251112091710.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 181023s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.ijmedinf.2017.10.014 |2 doi | |
| 035 | |a (DE-627)1582185220 | ||
| 035 | |a (DE-576)512185220 | ||
| 035 | |a (DE-599)BSZ512185220 | ||
| 035 | |a (OCoLC)1341020399 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rda | ||
| 041 | |a eng | ||
| 084 | |a 33 |2 sdnb | ||
| 100 | 1 | |a Kleczka, Bernadette |d 1984- |e VerfasserIn |0 (DE-588)116967206X |0 (DE-627)1035274698 |0 (DE-576)512184372 |4 aut | |
| 245 | 1 | 0 | |a Rubber stamp templates for improving clinical documentation |b a paper-based, m-Health approach for quality improvement in low-resource settings |c Bernadette Kleczka, Anita Musiega, Grace Rabut, Phoebe Wekesa, Paul Mwaniki, Michael Marx, Pratap Kumar |
| 264 | 1 | |c June 2018 | |
| 300 | |a 9 | ||
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Available online 23 October 2017 | ||
| 500 | |a Gesehen am 23.10.2018 | ||
| 520 | |a Background - The United Nations’ Sustainable Development Goal #3.8 targets ‘access to quality essential healthcare services’. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use of guidelines relies on cumbersome clinical audits of paper records, and electronic systems face financial and other limitations. Here we describe a unique approach to generating digital data from paper using guideline-based templates, rubber stamps and mobile phones. - Intervention - The Guidelines Adherence in Slums Project targeted ten private sector primary healthcare clinics serving informal settlements in Nairobi, Kenya. Each clinic was provided with rubber stamp templates to support documentation and management of commonly encountered outpatient conditions. Participatory design methods were used to customize templates to the workflows and infrastructure of each clinic. Rubber stamps were used to print templates into paper charts, providing clinicians with checklists for use during consultations. Templates used bubble format data entry, which could be digitized from images taken on mobile phones. Besides rubber stamp templates, the intervention included booklets of guideline compilations, one Android phone for digitizing images of templates, and one data feedback/continuing medical education session per clinic each month. In this paper we focus on the effect of the intervention on documentation of three non-communicable diseases in one clinic. - Methods - Seventy charts of patients enrolled in the chronic disease program (hypertension/diabetes, n=867; chronic respiratory diseases, n=223) at one of the ten intervention clinics were sampled. Documentation of each individual patient encounter in the pre-intervention (January-March 2016) and post-intervention period (May-July) was scored for information in four dimensions - general data, patient assessment, testing, and management. Control criteria included information with no counterparts in templates (e.g. notes on presenting complaints, vital signs). Documentation scores for each patient were compared between both pre- and post-intervention periods and between encounters documented with and without templates (post-intervention only). - Results - The total number of patient encounters in the pre-intervention (282) and post-intervention periods (264) did not differ. Mean documentation scores increased significantly in the post-intervention period on average by 21%, 24% and 17% for hypertension, diabetes and chronic respiratory diseases, respectively. Differences were greater (47%, 43% and 27%, respectively) when documentation with and without templates was compared. Changes between pre- vs.post-intervention, and with vs.without template, varied between individual dimensions of documentation. Overall, documentation improved more for general data and patient assessment than in testing or management. - Conclusion - The use of templates improves paper-based documentation of patient care, a first step towards improving the quality of care. Rubber stamps provide a simple and low-cost method to print templates on demand. In combination with ubiquitously available mobile phones, information entered on paper can be easily and rapidly digitized. This ‘frugal innovation’ in m-Health can empower small, private sector facilities, where large numbers of urban patients seek healthcare, to generate digital data on routine outpatient care. These data can form the basis for evidence-based quality improvement efforts at large scale, and help deliver on the SDG promise of quality essential healthcare services for all. | ||
| 650 | 4 | |a Clinical practice guideline | |
| 650 | 4 | |a Frugal innovation | |
| 650 | 4 | |a m-Health | |
| 650 | 4 | |a Non-physician clinician | |
| 650 | 4 | |a Rubber stamp template | |
| 700 | 1 | |a Musiega, Anita |e VerfasserIn |4 aut | |
| 700 | 1 | |a Rabut, Grace |e VerfasserIn |4 aut | |
| 700 | 1 | |a Wekesa, Phoebe |e VerfasserIn |4 aut | |
| 700 | 1 | |a Mwaniki, Paul |e VerfasserIn |4 aut | |
| 700 | 1 | |a Marx, Michael |d 1953- |e VerfasserIn |0 (DE-588)1054874638 |0 (DE-627)792352068 |0 (DE-576)410580368 |4 aut | |
| 700 | 1 | |a Kumur, Pratap |e VerfasserIn |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of medical informatics |d Amsterdam [u.a.] : Elsevier, 1997 |g 114(2018) vom: Juni, Seite 121-129 |h Online-Ressource |w (DE-627)265783720 |w (DE-600)1466296-6 |w (DE-576)074890913 |x 1872-8243 |7 nnas |a Rubber stamp templates for improving clinical documentation a paper-based, m-Health approach for quality improvement in low-resource settings |
| 773 | 1 | 8 | |g volume:114 |g year:2018 |g month:06 |g pages:121-129 |g extent:9 |a Rubber stamp templates for improving clinical documentation a paper-based, m-Health approach for quality improvement in low-resource settings |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.ijmedinf.2017.10.014 |x Verlag |x Resolving-System |3 Volltext |
| 856 | 4 | 0 | |u http://www.sciencedirect.com/science/article/pii/S1386505617303775 |x Verlag |3 Volltext |
| 951 | |a AR | ||
| 992 | |a 20181023 | ||
| 993 | |a Article | ||
| 994 | |a 2018 | ||
| 998 | |g 1054874638 |a Marx, Michael |m 1054874638:Marx, Michael |d 50000 |e 50000PM1054874638 |k 0/50000/ |p 6 | ||
| 998 | |g 116967206X |a Kleczka, Bernadette |m 116967206X:Kleczka, Bernadette |d 50000 |e 50000PK116967206X |k 0/50000/ |p 1 |x j | ||
| 999 | |a KXP-PPN1582185220 |e 3029481484 | ||
| BIB | |a Y | ||
| SER | |a journal | ||
| JSO | |a {"id":{"eki":["1582185220"],"doi":["10.1016/j.ijmedinf.2017.10.014"]},"person":[{"given":"Bernadette","family":"Kleczka","role":"aut","roleDisplay":"VerfasserIn","display":"Kleczka, Bernadette"},{"given":"Anita","family":"Musiega","roleDisplay":"VerfasserIn","role":"aut","display":"Musiega, Anita"},{"display":"Rabut, Grace","family":"Rabut","given":"Grace","roleDisplay":"VerfasserIn","role":"aut"},{"family":"Wekesa","given":"Phoebe","roleDisplay":"VerfasserIn","role":"aut","display":"Wekesa, Phoebe"},{"family":"Mwaniki","given":"Paul","roleDisplay":"VerfasserIn","role":"aut","display":"Mwaniki, Paul"},{"display":"Marx, Michael","given":"Michael","family":"Marx","role":"aut","roleDisplay":"VerfasserIn"},{"family":"Kumur","given":"Pratap","role":"aut","roleDisplay":"VerfasserIn","display":"Kumur, Pratap"}],"relHost":[{"physDesc":[{"extent":"Online-Ressource"}],"part":{"text":"114(2018) vom: Juni, Seite 121-129","volume":"114","year":"2018","pages":"121-129","extent":"9"},"disp":"Rubber stamp templates for improving clinical documentation a paper-based, m-Health approach for quality improvement in low-resource settingsInternational journal of medical informatics","pubHistory":["Volume 44, issue 1 (March 1997)-"],"title":[{"title_sort":"International journal of medical informatics","title":"International journal of medical informatics"}],"language":["eng"],"recId":"265783720","type":{"media":"Online-Ressource","bibl":"periodical"},"note":["Gesehen am 05.06.2018"],"origin":[{"publisherPlace":"Amsterdam [u.a.]","dateIssuedDisp":"1997-","dateIssuedKey":"1997","publisher":"Elsevier"}],"id":{"eki":["265783720"],"zdb":["1466296-6"],"issn":["1872-8243"]}}],"physDesc":[{"extent":"9 S."}],"name":{"displayForm":["Bernadette Kleczka, Anita Musiega, Grace Rabut, Phoebe Wekesa, Paul Mwaniki, Michael Marx, Pratap Kumar"]},"title":[{"title_sort":"Rubber stamp templates for improving clinical documentation","title":"Rubber stamp templates for improving clinical documentation","subtitle":"a paper-based, m-Health approach for quality improvement in low-resource settings"}],"language":["eng"],"recId":"1582185220","note":["Available online 23 October 2017","Gesehen am 23.10.2018"],"origin":[{"dateIssuedKey":"2018","dateIssuedDisp":"June 2018"}],"type":{"bibl":"article-journal","media":"Online-Ressource"}} | ||
| SRT | |a KLECZKABERRUBBERSTAM2018 | ||