Implementation and Evaluation of a System for Assessment of The Quality of Long-Term Management of Patients at a Geriatric Hospital

Background The use of a clinical decision support system for assessing the quality of care, based on computerized clinical guidelines (GLs), is likely to improve care, reduce costs, save time, and enhance the staff's capabilities. Objectives Implement and evaluate a system for assessment of the quality of the care, in the domain of management of pressure ulcers, by investigating the level of compliance of the staff to the GLs. Methods Using data for 100 random patients from the local EMR system we performed a technical evaluation, checking the applicability and usability, followed by a functional evaluation of the system investigating the quality metrics given to the compliance of the medical's staff to the protocol. We compared the scores given by the nurse when supported by the system, to the scores given by the nurse without the system's support, and to the scores given by the system. We also measured the time taken to perform the assessment with and without the system's support. Results There were no significant differences in the scores of most measures given by the nurse using the system, compared to the scores given by the system. There were also no significant differences across the values of most quality measures given by the nurse without support compared to the values given by the nurse with support. Using the system, however, significantly reduced the nurse's average assessment time. Conclusions Using an automated quality-assessment system, may enable a senior nurse, to quickly and accurately assess the quality of care. In addition to its accuracy, the system considerably reduces the time taken to assess the various quality measures.