Browsing by Author "Martinez-Motta, J Carlos"
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- ItemCritical care procedure logging using handheld computers.(2004-10-07) Martinez-Motta, J Carlos; Walker, Robin; Stewart, Thomas E; Granton, John; Abrahamson, Simon; Lapinsky, Stephen EINTRODUCTION We conducted this study to evaluate the feasibility of implementing an internet linked handheld computer procedure logging system in a critical care training program METHODS Subspecialty trainees in the Interdepartmental Division of Critical Care at the University of Toronto received and were trained in the use of Palm handheld computers loaded with a customized program for logging critical care procedures The procedures were entered into the handheld device using checkboxes and drop down lists and data were uploaded to a central database via the internet To evaluate the feasibility of this system we tracked the utilization of this data collection system Benefits and disadvantages were assessed through surveys RESULTS All 11 trainees successfully uploaded data to the central database but only six 55 continued to upload data on a regular basis The most common reason cited for not using the system pertained to initial technical problems with data uploading From 1 July 2002 to 30 June 2003 a total of 914 procedures were logged Significant variability was noted in the number of procedures logged by individual trainees range 13 242 The database generated by regular users provided potentially useful information to the training program director regarding the scope and location of procedural training among the different rotations and hospitals CONCLUSION A handheld computer procedure logging system can be effectively used in a critical care training program However user acceptance was not uniform and continued training and support are required to increase user acceptance Such a procedure database may provide valuable information that may be used to optimize trainees educational experience and to document clinical training experience for licensing and accreditation
- ItemProspective evaluation of an internet-linked handheld computer critical care knowledge access system.(2004-11-29) Lapinsky, Stephen E; Wax, Randy; Showalter, Randy; Martinez-Motta, J Carlos; Hallett, David; Mehta, Sangeeta; Burry, Lisa; Stewart, Thomas EINTRODUCTION Critical care physicians may benefit from immediate access to medical reference material We evaluated the feasibility and potential benefits of a handheld computer based knowledge access system linking a central academic intensive care unit ICU to multiple community based ICUs METHODS Four community hospital ICUs with 17 physicians participated in this prospective interventional study Following training in the use of an internet linked updateable handheld computer knowledge access system the physicians used the handheld devices in their clinical environment for a 12 month intervention period Feasibility of the system was evaluated by tracking use of the handheld computer and by conducting surveys and focus group discussions Before and after the intervention period participants underwent simulated patient care scenarios designed to evaluate the information sources they accessed as well as the speed and quality of their decision making Participants generated admission orders during each scenario which were scored by blinded evaluators RESULTS Ten physicians 59 used the system regularly predominantly for nonmedical applications median 32 8 month interquartile range IQR 28 3 126 8 with medical software accessed less often median 9 month IQR 3 7 13 7 Eight out of 13 physicians 62 who completed the final scenarios chose to use the handheld computer for information access The median time to access information on the handheld handheld computer was 19 s IQR 15 40 s This group exhibited a significant improvement in admission order score as compared with those who used other resources P 0 018 Benefits and barriers to use of this technology were identified CONCLUSION An updateable handheld computer system is feasible as a means of point of care access to medical reference material and may improve clinical decision making However during the study acceptance of the system was variable Improved training and new technology may overcome some of the barriers we identified