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Effectiveness of a multidisciplinary critical pathway based on a computerised physician order entry system for ST-segment elevation myocardial infarction management in the emergency department: a retrospective observational study

DC Field Value Language
dc.contributor.author김민정-
dc.contributor.author박유석-
dc.contributor.author박인철-
dc.contributor.author왕진원-
dc.contributor.author유제성-
dc.contributor.author이혜선-
dc.contributor.author정성필-
dc.contributor.author정현수-
dc.contributor.author홍정화-
dc.date.accessioned2017-10-26T07:19:03Z-
dc.date.available2017-10-26T07:19:03Z-
dc.date.issued2016-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/151875-
dc.description.abstractOBJECTIVES: The purpose of this study was to investigate whether a multidisciplinary organised critical pathway (CP) for ST-segment elevation myocardial infarction (STEMI) management can significantly attenuate differences in the duration from emergency department (ED) arrival to evaluation and treatment, regardless of the arrival time, by eliminating off-hour and weekend effects. DESIGN: Retrospective observational cohort study. SETTING: 2 tertiary academic hospitals. PARTICIPANTS: Consecutive patients in the Fast Interrogation Rule for STEMI (FIRST) program. INTERVENTIONS: A study was conducted on patients in the FIRST program, which uses a computerised physician order entry (CPOE) system. The patient demographics, time intervals and clinical outcomes were analysed based on the arrival time at the ED: group 1, normal working hours on weekdays; group 2, off-hours on weekdays; group 3, normal working hours on weekends; and group 4, off-hours on weekends. PRIMARY AND SECONDARY OUTCOME MEASURES: Clinical outcomes categorised according to 30-day mortality, in-hospital mortality and the length of stay. RESULTS: The duration from door-to-data or FIRST activation did not differ significantly among the 4 groups. The median duration between arrival and balloon placement during percutaneous coronary intervention did not significantly exceed 90?min, and the proportions (89.6-95.1%) of patients with door-to-balloon times within 90?min did not significantly differ among the 4 groups, regardless of the ED arrival time (p=0.147). Moreover, no differences in the 30-day (p=0.8173) and in-hospital mortality (p=0.9107) were observed in patients with STEMI. CONCLUSIONS: A multidisciplinary CP for STEMI based on a CPOE system can effectively decrease disparities in the door-to-data duration and proportions of patients with door-to-balloon times within 90?min, regardless of the ED arrival time. The application of a multidisciplinary CP may also help attenuate off-hour and weekend effects in STEMI clinical outcomes.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.publisherBMJ Publishing Group Ltd-
dc.relation.isPartOfBMJ OPEN-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHCritical Pathways*-
dc.subject.MESHDisease Management-
dc.subject.MESHEmergency Service, Hospital*-
dc.subject.MESHFemale-
dc.subject.MESHHospital Mortality-
dc.subject.MESHHumans-
dc.subject.MESHLength of Stay-
dc.subject.MESHMale-
dc.subject.MESHMedical Order Entry Systems*-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPatient Care Team-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHST Elevation Myocardial Infarction/diagnosis-
dc.subject.MESHST Elevation Myocardial Infarction/therapy*-
dc.subject.MESHTime Factors-
dc.subject.MESHTreatment Outcome-
dc.titleEffectiveness of a multidisciplinary critical pathway based on a computerised physician order entry system for ST-segment elevation myocardial infarction management in the emergency department: a retrospective observational study-
dc.typeArticle-
dc.publisher.locationEngland-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Emergency Medicine-
dc.contributor.googleauthorYoo Seok Park-
dc.contributor.googleauthorSung Phil Chung-
dc.contributor.googleauthorJe Sung You-
dc.contributor.googleauthorMin Joung Kim-
dc.contributor.googleauthorHyun Soo Chung-
dc.contributor.googleauthorJung Hwa Hong-
dc.contributor.googleauthorHye Sun Lee-
dc.contributor.googleauthorJinwon Wang-
dc.contributor.googleauthorIncheol Park-
dc.identifier.doi10.1136/bmjopen-2016-011429-
dc.contributor.localIdA01592-
dc.contributor.localIdA01628-
dc.contributor.localIdA04979-
dc.contributor.localIdA02507-
dc.contributor.localIdA03312-
dc.contributor.localIdA03625-
dc.contributor.localIdA03764-
dc.contributor.localIdA04433-
dc.contributor.localIdA00470-
dc.relation.journalcodeJ00380-
dc.identifier.eissn2044-6055-
dc.relation.journalsince2011~-
dc.identifier.pmid27531726-
dc.subject.keywordacute myocardial infarction-
dc.subject.keywordcomputerized physician order entry system-
dc.subject.keywordcritical pathway-
dc.subject.keywordemergency medicine-
dc.subject.keywordweekend effect-
dc.contributor.alternativeNameKim, Min Joung-
dc.contributor.alternativeNamePark, Yoo Seok-
dc.contributor.alternativeNamePark, In Cheol-
dc.contributor.alternativeNameWang, Jinwon-
dc.contributor.alternativeNameYou, Je Sung-
dc.contributor.alternativeNameLee, Hye Sun-
dc.contributor.alternativeNameChung, Sung Pil-
dc.contributor.alternativeNameChung, Hyun Soo-
dc.contributor.alternativeNameHong, Jung Hwa-
dc.contributor.affiliatedAuthorPark, Yoo Seok-
dc.contributor.affiliatedAuthorPark, In Cheol-
dc.contributor.affiliatedAuthorWang, Jinwon-
dc.contributor.affiliatedAuthorYou, Je Sung-
dc.contributor.affiliatedAuthorLee, Hye Sun-
dc.contributor.affiliatedAuthorChung, Sung Pil-
dc.contributor.affiliatedAuthorChung, Hyun Soo-
dc.contributor.affiliatedAuthorHong, Jung Hwa-
dc.contributor.affiliatedAuthorKim, Min Joung-
dc.citation.volume6-
dc.citation.number8-
dc.citation.startPage011429-
dc.identifier.bibliographicCitationBMJ OPEN, Vol.6(8) : 011429, 2016-
dc.date.modified2017-10-24-
dc.identifier.rimsid46200-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers

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