Validation of Surgical Intensive Care-Infection Registry: a medical informatics system for intensive care unit research, quality of care improvement, and daily patient care.
BACKGROUND
We developed a prototype electronic clinical information system called the Surgical Intensive Care-Infection Registry (SIC-IR) to prospectively study infectious complications and monitor quality of care improvement programs in the surgical and trauma intensive care unit. The objective of this study was to validate SIC-IR as a successful health information technology with an accurate clinical data repository.


METHODS
Using the DeLone and McLean Model of Information Systems Success as a framework, we evaluated SIC-IR in a 3-month prospective crossover study of physician use in one of our two surgical and trauma intensive care units (SIC-IR unit versus non SIC-IR unit). Three simultaneous research methodologies were used: a user survey study, a pair of time-motion studies, and an accuracy study of SIC-IR's clinical data repository.


RESULTS
The SIC-IR user survey results were positive for system reliability, graphic user interface, efficiency, and overall benefit to patient care. There was a significant decrease in prerounding time of nearly 4 minutes per patient on the SIC-IR unit compared with the non SIC-IR unit. The SIC-IR documentation and data archiving was accurate 74% to 100% of the time depending on the data entry method used. This accuracy was significantly improved compared with normal hand-written documentation on the non SIC-IR unit.


CONCLUSIONS
SIC-IR proved to be a useful application both at individual user and organizational levels and will serve as an accurate tool to conduct prospective research and monitor quality of care improvement programs.
Golob
Joseph F
JF
Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH 44109-998, USA.
Fadlalla
Adam M A
AM
Kan
Justin A
JA
Patel
Nilam P
NP
Yowler
Charles J
CJ
Claridge
Jeffrey A
JA
D000046:Academic Medical Centers; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003196:Computer Graphics; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D018592:Cross-Over Studies; D003625:Data Collection / Q000706:statistics & numerical data; D004282:Documentation / Q000592:standards; D017598:Efficiency, Organizational; D006751:Hospital Information Systems / Q000458:organization & administration*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007396:Internship and Residency; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000592:standards; D012042:Registries / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013996:Time and Motion Studies; D014584:User-Computer Interface