Case studies

Three case studies:

1 - Internal medicine department in large teaching hopsital in USA
2 - St John's Hospital medical team
3 - NHS Lanarkshire nurses' Hospital Emergency Care Teams

What a difference national policy makes:

- European Working Time Directive
- England (NPfIT) vs Scotland (free market implementation) vs USA (free market at all levels)

Internal medicine department in large teaching hopsital in USA

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In the beginning

- Senior asks IT department what the best available device is
- Junior doctor tells medical students that handheld computers essential for their studies

Investment

- $150,000
- 60 devices, WiFi
- UpToDate site license

Result

- 40 unopened boxes
- few residents and no medical students aware of UpToDate

St John's Hospital

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Doctors on the ward round can see:

- patient details filled in by admission staff
- lab results integrated from the pathology dept
- x-ray results integrated from radiology dept
- notes filled in during previous ward round
- reference documents

NHS Lanarkshire nurses

Hospital Emergency Care Teams

- Hospital at night has 2 specially trained Nurses + 5 medics
- Team manages all sick patients in the hospital. No JHOs.
- Nurses triage all calls, structured clinical assessments, IV cann, bloods inc ABG, ECGs, male cath, prescribe O2

Hector

- Very detailed activity data
- Ability to generate hand-over registers + reports
- Reference info at the bedside
- 24/7 availability, fast interaction, security
- Printed clinical assessments at the bedside