Specifications and needs assessment [1]
1 - INTRODUCTION
Hospitalists are wondering about the computerization of nursing units, including the information system and communication remains poorly understood and little studied because:
• the variety of nursing units in terms of diseases treated, but also of internal organization,
• the number and diversity of stakeholders both inside and outside the unit,
• the complexity and the bursting of the information processed.
Hospital management wanted further analysis of this system to better identify the needs of care units, a better knowledge of their business.
2 - THE STRATEGIC APPROACH
Several studies on information systems and communication within units of care and services medico-technical integrated hospital information system (HIS) were performed. These tests were based on the participation of major players in the health care unit of medical services
Technical: doctors, senior caregivers, nurses, technical staff. Hospital directors, the
responsible for information systems and organization (RSiO, DSIO), engineers and organization brought their computer experience, allowing for a specific approach and consistent system Information care unit.
These studies are essentially two objectives:
• providing guidelines for the computerization of care units (about 40,000) and medical services techniques to facilitate development in France of solutions tailored to the needs of hospitals public
• allow the definition of the bases could be French projects implementation, that would register as a contribution to projects initiated by the European Community.
3 - STUDIES CARRIED
3.1 Methodology
Hospital management has established for each study, multidisciplinary working groups to which
Computer services companies have provided technical support and systems analysis methodology information.
3.2 Presentation of study
In December 1986, the first study carried out with the Company Bossard Consultants described the overall information system and communication care units.
Performed in 6 hospitals (4 and 2 General Hospitals' among Hospital Academics), 18 wards were studied on the basis é inquiries and comments. The field of study covered
four sub-systems:
• monitoring of the patient
• planning tasks of the healthcare team
• keeping the various protocols,
• system of communication with other contacts in the hospital.
In September 1987, the second study conducted by the Company IOSC, had the objective analysis communication systems between the medico-technical departments and nursing units. 53 departments, divided into six hospitals (3 university hospitals and 3 General Hospital Centers), selected for their size, their medical specialties, their physical location and degree of computerization, were observed.
This study includes:
• A description of information systems and existing communication
• A review of their operation,
• Proposals for improvement by specialty, with guidance for their computerization.
In May 1988, the Department of Hospitals has made with the company Setec Computing an orientation study on the computerization of care units.
Besides a general framework of the domain, this work has enabled:
• specify the main requirements to cover
• setting out priorities in the consideration of these needs for the computerization of main functions
• Deepen a few priority themes,
• To consider possible directions for implementation.
In December 1988, following the work on the Nurse's Guide Service, the company has made 2SI a study specifying the action needed to computerize the information system in Care Nurses, including those of the two main areas:
• production of care:
• own role,
• prescribed role,
• piloting ways:
• planning workload,
• quantitative and qualitative monitoring of the production of care,
• resource management unit of care.
The third study focuses on the problems of the computerization of patient care units. It forms the basis of our presentation.
