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For any credible medical research to take place, pertinant data must be stored so that it can be instantly and accurately retrieved in any order and with whatever information is needed. Just as any business would not store client records and billing information in a filing cabinet where papers can be lost or mixed up, then hope to retrieve historical information on client trends and billing information with any accuracy and speed, so storing patient clinical records in a manual filing system cannot effectively improve quality assurance and provide credible statistics.
A computerised Emergency Unit clinical program is a crucial component of any hospital. It provides the necessary information for the hospital to conduct quality assurance, engage in injury surveillance, perform research and develop injury prevention and control strategies. In addition a computer program will allow administrators and clinicians alike to engage in evidence-based decision making, policy development and planning.
The information collected by a registry includes facts related to the patient demographics, the injury or event, the types and severity of injuries sustained in the event or medical condition, the process of care and patient outcomes.
WHY A COMPUTERISED EMERGENCY UNIT PROGRAM?
There are four main objectives of maintaining the registry. These are performance improvement, optimising hospital operations, injury and disease prevention and medical research. Of the four performance improvement is the primary reason for maintaining a registry. If utilised appropriately, performance improvement can be done in a much more efficient manner. Secondly the registry can help in managing resource utilisation through daily logs, summaries, etc. The registry helps to identify injury and disease control issues at the local, regional and national levels. Finally, by all designated facilities capturing standardised data, the information can be used in clinical research.
UTILISATION OF A COMPUTERISED EMERGENCY UNIT SYSTEM
MediBank is a computerised program that tracks a patient arriving in a Hospital Emergency Unit. It tracks this patient's progress from the scene, through the emergency unit, theatre visits, complications, ICU (if applicable) and discharge. The program calculates relevent internationally weighted scoring systems throughout. The user can then print any relevant data pertaining to that patient or any number of patients over a period of time. The strenght of MediBank is its ease of use allowing for data capture in minimal time and its ability to produce powerful statistical reports and instant graphs.
WHAT IS MEDIBANK?
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MediBank INCORPORATES TraumaBank. A LETTER FROM THE DESK OF THE PRESIDENT OF THE TRAUMA SOCIETY OF SOUTH AFRICA
Professor Ken Boffard
A Trauma Registry is simply a means of collecting and storing data relating to the type and management of trauma patients being seen in an institution. Internationally Trauma Registries are common practice, and would be considered mandatory for any Trauma Centre (or any practice requiring accurate and accessible records). “out there” there is a great deal of resistance to the impact that trauma has on all aspects of our lives. The most effective research and political lobbying tool created is accurate data.
South Africa is unique in terms of the quantity and severity of trauma seen. It is high time that we were able to analyse, present and compare our data in a scientific manner.
TraumaBank is a locally developed program designed to meet our needs. It is unique in that the software automatically calculates both the Injury Severity Score (ISS) and New Injury Severity Score (NISS) and predicted PROBABILITY OF SURVIVAL based on both these scores, at the stage when the first vitals were taken on the scene as well as on arrival in the Emergency Unit. It also incorporates an ICU module which can be used to score any ICU admission using the SAPSII, KES, APACHE II and SOFA scoring systems. The importance of being able to measure and benchmark the patient’s progress against multiple international scoring systems with such ease is an invaluable quality assurance tool.
The concept of being able to build up National statistics and trends based on information (which can be sent anonymously from participating centres) is an exciting one. This will facilitate injury surveillance, and allow for evidence-based decision making on a National level by TSSA with regards to policy making, planning and development of injury prevention and control strategies, as well as being able to lobby on the political stage, with hard data backup for the first time.
TraumaBank has been extensively tested at the Johannesburg Hospital (over 3400 patients logged during the past 18 months) as well as Milpark, Union, J F Jooste and Union (Swartklip).
With the imminent grading and verification of the delivery of Trauma Care at Trauma and Emergency Departments and Hospitals, the grading will depend to a significant extent on the ability to collect credible data on the patients treated. No Centre wishing to register as a site for research including drug trials would be considered without a working database of its patients.
President: Trauma Society of South Africa
TRAUMABANK: THE SOUTH AFRICAN NATIONAL TRAUMA REGISTRY
Website Last Modified 03/12/2008
MediBank now incorporates TraumaBank. TraumaBank was purely a trauma based registry. Medibank now allows for the capturing of all Emergency Unit patients and includes a comprehensive list of medical diagnoses, a triage tool and an ICU module.
HOW DOES MEDIBANK TRIAGE WORK?
Don't you hate going to an institution that asks you to wait to be helped but gives you no indication of how long you will be waiting or why? MediBank's triage tool is the answer for hospitals where patients have waiting periods in the Emergency Unit. Just like at an airport where a quick glance at the screen tells you exactly how long you will be waiting, so MediBank's active real time triage screen displays to your patients how long they can expect to wait and why. The patients are allocated a unique number and colour when they are triaged. While the patient waits to be treated a large screen automatically displays his or her number and severity in terms of a colour. That person can then view how many patients are ahead of him or her in the queue and severites in terms of a colour. The screen sorts the list of patients in order of severity. If a P3 patient arrives that patient is put at the end of the green (P3 colour) patients. If a P1 arrives that patient is placed at the top of the list behind any P1 patients that arrived previously. As patients are treated in the Emergency Unit inserting the time they where treated removes that patient from the list. Patient complaints are cut down to a minimum and should a patient complain later his arrival time, severity colour and treatment time can be instantly viewed. Hospital management can extract data such as when the Emergency Unit is at it's busiest and can plan staff rotation accordingly.