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Table 5 Knowledge management

From: Organizational interventions to implement improvements in patient care: a structured review of reviews

Author, number of studies Quality score Focus Main results
Balas 1996
N = 100
6 Computerized information services in different settings. A. provider prompt, B. provider feedback, C. computerized medical record, D. assisted treatment planning, E. computerized patient education. Improved test ordering/prevention in A (PSI 14/16 = 88%), B (PSI 7/9 = 78%), and C (PSI 6/8 = 75%). Improved drug prescription in D (PSI 10/12 = 83%). Improved patient knowledge in E (PSI 8/9 = 89%).
Balas 2004
N = 40
7 Computerized knowledge management in diabetes care. A. provider prompt, B. home glucose records Improved guideline compliance in A (PSI 6/8 = 75%). Improved glycated hemoglobin (SMD -0.14 mmol/L, S) and blood glucose (SMD -0.33 mmol/L, S) in B.
Currell 1999
N = 8
8 Nursing record systems No change in: patient care, patient outcomes. Some administrative benefits.
Kaushal 2003
N = 12
8 Physician order entry and clinical decision support systems Physician order entry: decrease in serious medication error (PSI 2/5 = 40%), improved in collollary orders (PSI 1/5 = 20%), improved prescribing behaviors (PSI 100%), improved nephrotoxic drug dose and frequency (PSI 1/5 = 20%). Decision support: improved antibiotic-associated medication errors and adverse drug events (PSI 3/7 = 43%), improvement in theophylinne-associated medication errors (PSI 1/7 = 14%).
Mitchell 2001
N = 61
7 Computer systems in primary care Increased consultation length (SMD range 48–130 seconds). Improved immunization rates (ARR range 8–34%). Reduced test ordering (ARR range 6–75%). Improved patient outcomes (PSI 17/89 = 19%).
Walton 1999
N = 15
8 Computerized decision support on medication prescribing Blood concentration of drug (AES 0.69, S), time to reach therapeutic concentration (AES – 0.44, S), patient outcomes (PSI5/6 = 83%), cost savings (PSI 2/2 = 100%)