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Impact of telemedicine in hospital culture and its consequences on quality of care and safety.
Steinman, Milton; Morbeck, Renata Albaladejo; Pires, Philippe Vieira; Abreu Filho, Carlos Alberto Cordeiro; Andrade, Ana Helena Vicente; Terra, Jose Claudio Cyrineu; Teixeira Junior, José Carlos; Kanamura, Alberto Hideki.
Afiliação
  • Steinman M; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Morbeck RA; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Pires PV; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Abreu Filho CA; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Andrade AH; Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil.
  • Terra JC; Sociedade Beneficente Israelita, São Paulo, SP, Brazil.
  • Teixeira Junior JC; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
  • Kanamura AH; Sociedade Beneficente Israelita, São Paulo, SP, Brazil.
Einstein (Sao Paulo) ; 13(4): 580-6, 2015.
Article em En, Pt | MEDLINE | ID: mdl-26676268
OBJECTIVE: To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. METHODS: The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. RESULTS: Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. CONCLUSION: The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade da Assistência à Saúde / Cultura Organizacional / Telemedicina / Atenção à Saúde / Segurança do Paciente Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Aspecto: Determinantes_sociais_saude Limite: Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Einstein (Sao Paulo) Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Qualidade da Assistência à Saúde / Cultura Organizacional / Telemedicina / Atenção à Saúde / Segurança do Paciente Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Aspecto: Determinantes_sociais_saude Limite: Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Einstein (Sao Paulo) Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil País de publicação: Brasil