Impact of telemedicine in hospital culture and its consequences on quality of care and safety

Detalhes bibliográficos
Autor(a) principal: Steinman,Milton
Data de Publicação: 2015
Outros Autores: Morbeck,Renata Albaladejo, Pires,Philippe Vieira, Abreu Filho,Carlos Alberto Cordeiro, Andrade,Ana Helena Vicente, Terra,Jose Claudio Cyrineu, Teixeira Junior,José Carlos, Kanamura,Alberto Hideki
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Einstein (São Paulo)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000400580
Resumo: ABSTRACT Objective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.
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spelling Impact of telemedicine in hospital culture and its consequences on quality of care and safetyTelemedicineSafetyPatient safetyQuality of health careEmergenciesABSTRACT Objective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.Instituto Israelita de Ensino e Pesquisa Albert Einstein2015-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000400580einstein (São Paulo) v.13 n.4 2015reponame:Einstein (São Paulo)instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)instacron:IIEPAE10.1590/S1679-45082015GS2893info:eu-repo/semantics/openAccessSteinman,MiltonMorbeck,Renata AlbaladejoPires,Philippe VieiraAbreu Filho,Carlos Alberto CordeiroAndrade,Ana Helena VicenteTerra,Jose Claudio CyrineuTeixeira Junior,José CarlosKanamura,Alberto Hidekieng2016-01-05T00:00:00Zoai:scielo:S1679-45082015000400580Revistahttps://journal.einstein.br/pt-br/ONGhttps://old.scielo.br/oai/scielo-oai.php||revista@einstein.br2317-63851679-4508opendoar:2016-01-05T00:00Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)false
dc.title.none.fl_str_mv Impact of telemedicine in hospital culture and its consequences on quality of care and safety
title Impact of telemedicine in hospital culture and its consequences on quality of care and safety
spellingShingle Impact of telemedicine in hospital culture and its consequences on quality of care and safety
Steinman,Milton
Telemedicine
Safety
Patient safety
Quality of health care
Emergencies
title_short Impact of telemedicine in hospital culture and its consequences on quality of care and safety
title_full Impact of telemedicine in hospital culture and its consequences on quality of care and safety
title_fullStr Impact of telemedicine in hospital culture and its consequences on quality of care and safety
title_full_unstemmed Impact of telemedicine in hospital culture and its consequences on quality of care and safety
title_sort Impact of telemedicine in hospital culture and its consequences on quality of care and safety
author Steinman,Milton
author_facet Steinman,Milton
Morbeck,Renata Albaladejo
Pires,Philippe Vieira
Abreu Filho,Carlos Alberto Cordeiro
Andrade,Ana Helena Vicente
Terra,Jose Claudio Cyrineu
Teixeira Junior,José Carlos
Kanamura,Alberto Hideki
author_role author
author2 Morbeck,Renata Albaladejo
Pires,Philippe Vieira
Abreu Filho,Carlos Alberto Cordeiro
Andrade,Ana Helena Vicente
Terra,Jose Claudio Cyrineu
Teixeira Junior,José Carlos
Kanamura,Alberto Hideki
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Steinman,Milton
Morbeck,Renata Albaladejo
Pires,Philippe Vieira
Abreu Filho,Carlos Alberto Cordeiro
Andrade,Ana Helena Vicente
Terra,Jose Claudio Cyrineu
Teixeira Junior,José Carlos
Kanamura,Alberto Hideki
dc.subject.por.fl_str_mv Telemedicine
Safety
Patient safety
Quality of health care
Emergencies
topic Telemedicine
Safety
Patient safety
Quality of health care
Emergencies
description ABSTRACT Objective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.
publishDate 2015
dc.date.none.fl_str_mv 2015-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000400580
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082015000400580
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1679-45082015GS2893
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Instituto Israelita de Ensino e Pesquisa Albert Einstein
publisher.none.fl_str_mv Instituto Israelita de Ensino e Pesquisa Albert Einstein
dc.source.none.fl_str_mv einstein (São Paulo) v.13 n.4 2015
reponame:Einstein (São Paulo)
instname:Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)
instacron:IIEPAE
instname_str Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)
instacron_str IIEPAE
institution IIEPAE
reponame_str Einstein (São Paulo)
collection Einstein (São Paulo)
repository.name.fl_str_mv Einstein (São Paulo) - Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE)
repository.mail.fl_str_mv ||revista@einstein.br
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