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Ann Thorac Surg 2000;69:1817-1821
© 2000 The Society of Thoracic Surgeons

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Original articles: Cardiovascular

Collection of process data after cardiac surgery: initial implementation with a Java-based intranet applet

^a Division of Cardiothoracic Surgery, Department of Surgery, School of Medicine of the University of California, San Francisco and the San Francisco Veterans Affairs Medical Center, San Francisco, California, USA

Address reprint requests to Dr Ratcliffe, VAMC Surgery 112D, San Francisco Veterans Affairs Medical Center, 4150 Clement St, San Francisco, CA 94121
e-mail: ratcliffe.mark{at}sanfrancisco.va.gov

Background. Using a Java-based intranet program (applet), we collected postoperative process data after coronary artery bypass grafting.

Methods. A Java-based applet was developed and deployed on a hospital intranet. Briefly, the nurse entered patient process data using a point and click interface. The applet generated a nursing note, and process data were saved in a Microsoft Access database. In 10 patients, this method was validated by comparison with a retrospective chart review. In 45 consecutive patients, weekly control charts were generated from the data. When aberrations from the pathway occurred, feedback was initiated to restore the goals of the critical pathway.

Results. The intranet process data collection method was verified by a manual chart review with 98% sensitivity. The control charts for time to extubation, intensive care unit stay, and hospital stay showed a deviation from critical pathway goals after the first 20 patients. Feedback modulation was associated with a return to critical pathway goals.

Conclusions. Java-based applets are inexpensive and can collect accurate postoperative process data, identify critical pathway deviations, and allow timely feedback of process data.

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