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computerization

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During the relief and treatment of 'large' groups of victims showed that a simple and effective information facility is a prerequisite for proper treatment possibilities. That is why in the Major Incident Hospital the specific applications has been developed: the Patient Barcode Registration System (PBR system). These systems are for the support of medical, nursing and logistic handling in the Major Incident Hospital.

PBRS

The Patient Barcode Registration system (PBRS) is a computerized registration system, in which data can be entered besides via the keyboard also by means of bar codes. Among others personal data of the patients can be entered. The PBR system is for the support of medical, nursing and logistic handling during admission and treatment in the MIH.

The main objective of the PBRS system is to register patient data quickly and qualitatively correct by assistants in order to pass the medical co-ordination during a mass casualty incident optimally. In the system data can be registered such as urgencies, routing, names, addresses, dwelling places, birth data, location data, arrival and depart times. Beside it group level data can be established.

Data can be entered at more places. The computers ('stations'), where this data is entered, are connected in a network with each other. Data is stored in a central database. Bar codes may be used as information carrier for the entering of data. This increases the rapidity of entering and guarantees the quality of data.

Objectives and development PBRS

The use and the further development of the PBRS focuses primarily on:

  • Simplifying of registration and identification of patients
  • Localization of patients
  • Collecting and registering of urgencies
  • Generating reports for aiding co-ordination
  • Exchanging data with the Hospital Information eXchange System (HIX)
  • Supporting analysis afterwards

Because of above-mentioned, the PBRS contributes to the quality of care during mass casualty incidents by:

  • Improvement of the co-ordination of care to patients
  • Facilitating of medical and nursing treatment
  • Making possible of quality assurance afterwards
  • Localization of patients
  • Continuous triage of patients by central information facilities

PBRS in practice

When a patient arrives in the ambulance hall during a mass casualty incident, the concerning patient gets a wristband with a bar code on it. This bar code corresponds with an in advance reserved patient number. A patient file which stays near the patient belongs to this number, also with a bar code. In the ambulance hall the coordinating nurse determines where the patient goes to. The PBRS-assistant who works with the PBRS, need not to be a computer expert. This PBRS-assistant scans the wristband of the patient by a bar code scanner first. Then data is registered by means of so called "templates". On these templates data can be represented such as urgencies, medical indications or routing.
Then the patient goes to the Triage and treatment ward where the doctor divides the patients into urgency classes. The PBRS-assistant scans the number of the patient again whereby earlier entered data appear on the screen. Subsequently the clinical urgencies are indicated by these templates.
 
Next patients go to one of the sections in the triage and treatment ward. Patients with the highest urgency go to section red, the patients who need a treatment within 6 hours go to section yellow. Patients that need minimal treatment go to section green, In the triage and treatment ward the patients are screened thoroughly.

Subsequent medical indications and the routing of the patient are indicated near the exit of the triage and treatment ward. Then the patient continues the way to the X-ray department, the Operating Room, the Intensive Care, the Medium Care or the Low Care.

In the nursing departments bed locations can be entered in the PBRS. Personal data can be entered in every registration station. In practice this is usually done in the nursing departments. In the treatment departments a/o. treatment data can be indicated.
 
By the PBRS it is possible to generate patient reports of the data which has been entered. It is also possible to generate total views of patients. By above-mentioned data it is also possible to support the evaluation of the admission afterwards. In the nursing departments it is possible to print bar code labels by bar code printers.
 
The PBRS is applied in a logical considerate separated network. This network makes physical (concerning the infrastructure) use of the cables of the University Medical Centre Utrecht network, but has an own central computer, the so-called 'server'. It is possible to exchange data with the Hospital Information eXchange System (HIX). This communication is bi-directional, because it is needed to inspect data in the HIX which is entered in the PBRS and v.v. From every registration point can directly be communicated with the HIX. If the HIX falls out, then it doesn't generate an obstruction to the PBRS.