[ABCDEF: Tool to transform the systems for the registry of institutional information].

Ulises Trejo-Amador, Montserrat Legorreta-Rojas
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Abstract

Health systems require instruments that allow the generation of real, concrete, specific and objective information that can be named, classified, shared and compared internationally. Nowadays, this premise is possible, thanks to the specific and particular characteristics of information technologies needs in health, the speed in the generation of knowledge, the technological changes in telecommunications and its current development. However, there are areas of opportunity in information systems that make difficult this paradigm. Many of these areas are in the hands of health professionals themselves, who work directly with primary sources of information. Given this panorama, by applying an awareness and measurement tool, we can contribute to identifying areas of opportunity in order to favor the adequate recording of information, mainly hospital discharges, which has an impact on the biased and incorrect generation of morbidity statistics and hospital mortality, the diversion of financial, human, and material resources and, of course, the impossibility of implementing hospital management tools such as diagnostic related groups (DRG). It is interesting that in order for certain areas of opportunity to occur, in this case those related to the clinical record, it is investigated the feeling that each worker has about the work environment in their organization, that is to say, about the work environment, if they feel taken into account, trained, fed back, valued and part of the positive change in their work environment so that they feel motivated to do their work in accordance with regulations.

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[ABCDEF:机构信息登记系统改造工具]。
卫生系统需要能够生成真实、具体、具体和客观信息的工具,这些信息可以在国际范围内命名、分类、共享和比较。如今,这一前提已经成为可能,这要归功于卫生领域所需的信息技术的具体和特殊性、知识生成的速度、电信技术的变革及其当前的发展。然而,信息系统中的一些机遇领域使这一模式难以实现。其中许多领域是由卫生专业人员自己掌握的,他们直接与主要信息来源打交道。在这种情况下,通过使用一种认识和测量工具,我们可以帮助确定机会领域,以促进对信息(主要是出院信息)的充分记录,这将影响到发病率统计和医院死亡率统计的偏差和错误生成、财力、人力和物力资源的分散,当然也会影响到诸如诊断相关组(DRG)等医院管理工具的无法实施。值得注意的是,为了使某些领域(这里指的是与临床记录有关的领域)出现机会,需要 调查每个工作人员对其所在单位工作环境的感受,也就是说,调查他们对工作环境的感受, 看看他们是否觉得自己的工作环境得到了考虑、培训、反馈、重视和积极改变,从而使他们有 动力按照规定开展工作。
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