PDF(Pubmed)
Abstract：
BACKGROUND: This study demonstrates that digital maturity contributes to strengthened quality and safety performance outcomes in US hospitals. Advanced digital maturity is associated with more digitally enabled work environments with automated flow of data across information systems to enable clinicians and leaders to track quality and safety outcomes. This research illustrates that an advanced digitally enabled workforce is associated with strong safety leadership and culture and better patient health and safety outcomes.
OBJECTIVE: This study aimed to examine the relationship between digital maturity and quality and safety outcomes in US hospitals.
METHODS: The data sources were hospital safety letter grades as well as quality and safety scores on a continuous scale published by The Leapfrog Group. We used the digital maturity level (measured using the Electronic Medical Record Assessment Model [EMRAM]) of 1026 US hospitals. This was a cross-sectional, observational study. Logistic, linear, and Tweedie regression analyses were used to explore the relationships among The Leapfrog Group\'s Hospital Safety Grades, individual Leapfrog safety scores, and digital maturity levels classified as advanced or fully developed digital maturity (EMRAM levels 6 and 7) or underdeveloped maturity (EMRAM level 0). Digital maturity was a predictor while controlling for hospital characteristics including teaching status, urban or rural location, hospital size measured by number of beds, whether the hospital was a referral center, and type of hospital ownership as confounding variables. Hospitals were divided into the following 2 groups to compare safety and quality outcomes: hospitals that were digitally advanced and hospitals with underdeveloped digital maturity. Data from The Leapfrog Group\'s Hospital Safety Grades report published in spring 2019 were matched to the hospitals with completed EMRAM assessments in 2019. Hospital characteristics such as number of hospital beds were obtained from the CMS database.
RESULTS: The results revealed that the odds of achieving a higher Leapfrog Group Hospital Safety Grade was statistically significantly higher, by 3.25 times, for hospitals with advanced digital maturity (EMRAM maturity of 6 or 7; odds ratio 3.25, 95% CI 2.33-4.55).
CONCLUSIONS: Hospitals with advanced digital maturity had statistically significantly reduced infection rates, reduced adverse events, and improved surgical safety outcomes. The study findings suggest a significant difference in quality and safety outcomes among hospitals with advanced digital maturity compared with hospitals with underdeveloped digital maturity.
OBJECTIVE: This study aimed to examine the relationship between digital maturity and quality and safety outcomes in US hospitals.
METHODS: The data sources were hospital safety letter grades as well as quality and safety scores on a continuous scale published by The Leapfrog Group. We used the digital maturity level (measured using the Electronic Medical Record Assessment Model [EMRAM]) of 1026 US hospitals. This was a cross-sectional, observational study. Logistic, linear, and Tweedie regression analyses were used to explore the relationships among The Leapfrog Group\'s Hospital Safety Grades, individual Leapfrog safety scores, and digital maturity levels classified as advanced or fully developed digital maturity (EMRAM levels 6 and 7) or underdeveloped maturity (EMRAM level 0). Digital maturity was a predictor while controlling for hospital characteristics including teaching status, urban or rural location, hospital size measured by number of beds, whether the hospital was a referral center, and type of hospital ownership as confounding variables. Hospitals were divided into the following 2 groups to compare safety and quality outcomes: hospitals that were digitally advanced and hospitals with underdeveloped digital maturity. Data from The Leapfrog Group\'s Hospital Safety Grades report published in spring 2019 were matched to the hospitals with completed EMRAM assessments in 2019. Hospital characteristics such as number of hospital beds were obtained from the CMS database.
RESULTS: The results revealed that the odds of achieving a higher Leapfrog Group Hospital Safety Grade was statistically significantly higher, by 3.25 times, for hospitals with advanced digital maturity (EMRAM maturity of 6 or 7; odds ratio 3.25, 95% CI 2.33-4.55).
CONCLUSIONS: Hospitals with advanced digital maturity had statistically significantly reduced infection rates, reduced adverse events, and improved surgical safety outcomes. The study findings suggest a significant difference in quality and safety outcomes among hospitals with advanced digital maturity compared with hospitals with underdeveloped digital maturity.
摘要：
背景：这项研究表明，数字成熟度有助于增强美国医院的质量和安全绩效结果。先进的数字化成熟度与更数字化的工作环境相关，这些工作环境具有跨信息系统的自动化数据流，使临床医生和领导者能够跟踪质量和安全结果。这项研究表明，先进的数字化员工队伍与强大的安全领导力和文化以及更好的患者健康和安全成果相关联。
目的：本研究旨在研究美国医院数字化成熟度与质量和安全性结果之间的关系。
方法：数据来源是医院安全信函等级以及由TheLeapfrogGroup发布的连续量表上的质量和安全评分。我们使用了1026家美国医院的数字成熟度水平（使用电子病历评估模型[EMRAM]进行测量）。这是一个横截面，观察性研究。物流,线性,和Tweedie回归分析用于探索跨越式集团医院安全等级之间的关系，个人跳跃安全评分，和数字成熟度级别分类为高级或完全开发的数字成熟度（EMRAM级别6和7）或不发达的成熟度（EMRAM级别0）。数字成熟度是一个预测指标，同时控制医院特征，包括教学状况，城市或农村的位置，以床位数量衡量的医院规模，医院是否是转诊中心，和医院所有权类型作为混杂变量。医院分为以下两组以比较安全性和质量结果：数字化先进的医院和数字化成熟度不足的医院。2019年春季发布的LeapfrogGroup医院安全等级报告的数据与2019年完成EMRAM评估的医院相匹配。从CMS数据库获得医院特征，例如病床数量。
结果：结果显示，获得更高的跨越式集团医院安全等级的几率在统计学上明显更高，3.25倍，对于数字成熟度较高的医院(EMRAM成熟度为6或7；比值比3.25，95%CI2.33-4.55)。
结论：数字成熟度较高的医院在统计学上显著降低了感染率，减少不良事件，并改善手术安全性结果。研究结果表明，与数字成熟度不足的医院相比，数字成熟度较高的医院在质量和安全结果方面存在显着差异。
目的：本研究旨在研究美国医院数字化成熟度与质量和安全性结果之间的关系。
方法：数据来源是医院安全信函等级以及由TheLeapfrogGroup发布的连续量表上的质量和安全评分。我们使用了1026家美国医院的数字成熟度水平（使用电子病历评估模型[EMRAM]进行测量）。这是一个横截面，观察性研究。物流,线性,和Tweedie回归分析用于探索跨越式集团医院安全等级之间的关系，个人跳跃安全评分，和数字成熟度级别分类为高级或完全开发的数字成熟度（EMRAM级别6和7）或不发达的成熟度（EMRAM级别0）。数字成熟度是一个预测指标，同时控制医院特征，包括教学状况，城市或农村的位置，以床位数量衡量的医院规模，医院是否是转诊中心，和医院所有权类型作为混杂变量。医院分为以下两组以比较安全性和质量结果：数字化先进的医院和数字化成熟度不足的医院。2019年春季发布的LeapfrogGroup医院安全等级报告的数据与2019年完成EMRAM评估的医院相匹配。从CMS数据库获得医院特征，例如病床数量。
结果：结果显示，获得更高的跨越式集团医院安全等级的几率在统计学上明显更高，3.25倍，对于数字成熟度较高的医院(EMRAM成熟度为6或7；比值比3.25，95%CI2.33-4.55)。
结论：数字成熟度较高的医院在统计学上显著降低了感染率，减少不良事件，并改善手术安全性结果。研究结果表明，与数字成熟度不足的医院相比，数字成熟度较高的医院在质量和安全结果方面存在显着差异。
