Patient and staff management system

The present invention relates to a patient / staff management system that manages the state and behavior of patients and staff in a hospital.

There is known a technique for grasping the patient's condition in a hospital by using the measured values of various sensors (for example, a bed leaving sensor for monitoring the patient's behavior on the bed, a tube pull-out sensor, an infrared sensor, etc.).

In addition, as a technology for managing patients and staff, a technology for monitoring a flow line by attaching an RFID tag to a patient or staff (for example, Patent Document 1) and a technology for issuing an alarm when the patient or staff does not move according to a schedule (for example, Patent Document). 2) etc. are known.<patcit num="1"><text>Japanese Patent Application Laid-Open No. 2002-312471</text></patcit><patcit num="2"><text>Japanese Unexamined Patent Publication No. 2005-278864</text></patcit>

<p> However, in the prior art, the abnormality determination condition of the sensor measurement value for issuing a nurse call or the like is set fixedly or individually. Therefore, when the abnormality determination condition is fixed, there is a problem that the sensor always makes the same determination even though the state is different for each patient. On the other hand, when the abnormal conditions of various sensors are changed and set for each patient, there is a problem that it is difficult to start or end the application of the sensors or change the abnormal conditions. That is, there is a problem that it is not possible to flexibly respond to the assessment performed for each patient, the order frequently exchanged between staff members, and the treatment schedule.</p><p> Therefore, an object of the present invention is to provide a patient / staff management system capable of automatically implementing measures according to the measurement results of sensors without changing the settings of various sensors for each patient.</p>

<p> The patient / staff management system according to the present invention records the treatment and treatment schedule and implementation record for the patient by time zone based on the assessment of the patient, the order exchanged between the hospital staff, and the standard treatment schedule for each disease. The patient / staff status output unit that acquires the measured values of various sensors installed in the hospital and converts the patient / staff status into the patient / staff status output unit, and the treatment. The treatment schedule / implementation record is acquired from the schedule / implementation record holding unit, the status of the patient and the staff is acquired from the patient / staff status output unit, and the acquired treatment schedule / implementation record and the patient and the patient are described. It is provided with a comparison unit for comparing the state of staff and a call / alarm unit for calling / alarming various terminals in the hospital according to the comparison result obtained from the comparison unit.</p>

<p> According to the present invention, there is provided a patient / staff management system that can automatically take measures according to the measurement results of the sensors without changing the settings of various sensors for each patient.</p>

(Embodiment 1) Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing an overall configuration example of an embodiment of the present invention.

The patient / staff management system according to the present embodiment is composed of a patient / staff management device 1, a terminal 2, and a sensor 3, and these devices are connected via a network 4.

The patient / staff management device 1 includes a treatment schedule / implementation record holding unit 11, a treatment schedule / implementation record unit 12, a patient / staff status output unit 13, a countermeasure table holding unit 14, a comparison unit 15, and a calling / alarm unit 16. It is a equipped computer.

Terminal 2 is various terminals such as personal computers (PCs) and PDAs used by doctors, nurses, pharmacists, etc. in hospitals.

Sensor 3 is a variety of sensors installed in the hospital, such as sensors that monitor patient behavior on the bed (such as bed leaving sensors, tube pull-out sensors, infrared sensors, etc.), and RFID tags carried by patients and staff. RFID readers that receive wireless radio waves and monitor their positions, and sensor for the remaining amount of drip / syringe pumps.

Hereinafter, the functions of each part constituting the patient / staff management device 1 will be described in detail.

1. Treatment schedule / implementation record holding unit The treatment schedule / implementation record holding unit 11 is a database that retains the treatment schedule / treatment schedule and implementation record for the patient as a treatment schedule / implementation record table. FIG. 2 is a diagram showing a specific example of the treatment schedule / implementation record table. In this treatment schedule / implementation record table, meals, rest, excretion, treatment, drug information, test contents, etc. are recorded for each date and time zone. In application to individual patients, the content of the implementation schedule shall be changed as appropriate according to the course and condition of treatment of the patient. It is preferable that the treatment schedule / implementation record table has the same format as the clinical pathway (standard treatment process for each disease).

In the present embodiment, the disease of the patient is specified by the doctor, the clinical path for the specified disease is applied to the patient, and the treatment schedule / implementation record holding unit 11 as the treatment schedule / implementation record table of the patient. It is held in.

For example, in Fig. 2, January 23, 2007 is the scheduled surgery date, and the patient is prescribed a sleeping pill during the bedtime of the day before the surgery, and an intravenous drip (antibiotic, etc.) is prescribed after the surgery. In addition, the degree of rest of the patient (what range of the patient is allowed in the hospital and what kind of behavior is allowed) is set in each time zone before and after the surgery. In addition, the treatment schedule / implementation record table records the doctor in charge and the nurse in charge for each time zone.

In addition, staff such as doctors and nurses can change the implementation schedule for each meal, rest, excretion, treatment date, and time zone on the treatment schedule / implementation record table according to the patient's condition and the course of treatment.

In addition, in the treatment schedule / implementation record table, for each item such as meal, rest, excretion, etc., the display color of the cell corresponding to the current time zone is different from the color of other cells, and each item in the current time zone It is created so that the contents of the items can be easily understood. Furthermore, for items such as drugs and tests, the cell display color depends on the situation such as "new", "change", "instruction received", "implemented", "implemented (in the case of intravenous drip, etc.)". Can be further subdivided.

In addition, the treatment schedule / implementation record table can be displayed on the terminal 2 such as a PC or PDA used by doctors and nurses for existing ordering systems and electronic medical records.

Furthermore, the treatment schedule / implementation record table can be one screen in the existing ordering system or electronic medical record, and can be linked with the existing ordering system or electronic medical record. For example, when a doctor issues a new drug order on an existing ordering system or electronic medical record, in response to this, a new cell is added to the cell of the time zone to which the scheduled prescription time specified in the order belongs on the treatment schedule / implementation record table. The prescription of the drug is displayed.

In addition, a concrete example of the method of specifying the cell of the current time zone for each item such as rest level and meal on the treatment schedule / implementation record table is shown below. -According to the passage of time, the daytime time zone is automatically started when the patient wake-up time specified by the hospital is reached, and the bedtime time zone is automatically started when the light-off time is reached. The hospital's prescribed working hours are automatically applied according to the passage of time (for example, in the case of 3 shifts, day shift, semi-night shift, midnight shift).

Furthermore, for detailed time zones such as "before surgery" and "after surgery", the time zone can be specified as follows. When the patient wakes up on the day of surgery, it is automatically set as "before surgery". -When the target patient position is measured as the operating room (or its entrance) by the patient / staff status output unit 13, it is considered as "in operation". In addition, when a barcode or bedside terminal 2 is used for patient confirmation during transportation to the operating room, the execution record of patient confirmation using the barcode can be used as in operation. -If it is specified that the patient has returned to the bed from the output result of the patient / staff status output unit 13 related to the camera in the hospital room or the pressure sensor of the bed, it is considered as "after surgery".

2. Treatment schedule / implementation record department The treatment schedule / implementation record unit 12 records the treatment schedule / implementation record input from the terminal 2 used by doctors and nurses for the existing ordering system and electronic medical records in the treatment schedule / implementation record holding unit 11. It is a program to do. That is, the recorded contents of instruction reception and execution recorded by the existing ordering system or electronic medical record are recorded as the implementation status of each cell on the treatment schedule / implementation record table. For example, a nurse confirms a newly generated instruction from a doctor with an existing ordering system or electronic medical record, and records that the nurse has received an instruction with the instruction reception confirmation record function of the ordering system or electronic medical record. To do. In addition, for the patient, when the drug is actually administered according to the instruction, it is recorded by the ordering system or the instruction execution confirmation recording function of the electronic medical record.

FIG. 3 is a flowchart showing a specific example of the processing of the treatment schedule / implementation recording unit 12. While in the standby state (step 3a), it is determined whether or not the patient ID, implementation content, implementation time, implementation staff ID, etc. have been input from the terminal 2 such as a barcode or PC (step 3b). Here, if there is input information, the input information is recorded in the treatment schedule / implementation record table (step 3c), and the process proceeds to step 3d. On the other hand, if there is no input information, the process proceeds to step 3d.

In step 3d, it is determined whether or not the position information of the staff is received from the patient / staff status output unit 13. Here, when the position information of the staff is received, it is determined whether or not the position of the staff is the bedside of the patient (step 3e). On the other hand, if it is determined that the staff position information has not been received, the process returns to step 3a.

If it is determined in step 3e that the staff position is the patient's bedside, enter the staff ID and visit time as implementation records in the treatment schedule / implementation record table for the relevant patient (step 3f), and step 3a. Return to. On the other hand, if the staff position is not the patient's bedside, return to step 3a. 3. Patient / staff status output unit The patient / staff status output unit 13 is a program that outputs the status of each patient and each staff from the measured values of various sensors 3 installed in the hospital. FIG. 4 is a diagram showing a specific example of the output contents of the patient / staff status output unit 13 with respect to the measured value of the sensor 3.

For example, in the case of a pressure sensor installed on a bed, the position of the center of gravity of a person on the bed is measured. For example, if the position of the center of gravity of a patient k's bed changes in a certain direction (for example, from the vicinity of the center of the bed to the periphery of the bed) at a certain time t, the patient's condition is "trying to get out of bed". To correspond. Further, the patient identification number k and the measurement time t are attached, and "patient k is about to get out of bed at time t" is output as the patient state.

In addition, when the hospital staff is allowed to carry the RFID tag and the position of the hospital staff is measured by the RFID readers installed in various places in the hospital, the measurement area of each RFID reader is defined in advance. Then, at time t, when the RFID tag carried by the staff s is measured by the RFID reader corresponding to the region r, "in the region r" is associated with the measured value of the RFID as the staff status. Further, "Staff s is in the area r at time t" with the staff identification number s and the measurement time t is output.

In the case of a camera, it is necessary to identify the patient or staff by collating the face database with respect to the measured image. This collation function may be built in the patient / staff status output unit 13. If the camera is equipped with a collation function and the output result of the camera includes the identification number (patient identification number or staff identification number) of the person to be measured, the collation result of the camera is used for output. If necessary, the measurement area of the camera (hospital gate, ward entrance, etc.) and the measurement time may be combined and output.

In this way, the patient / staff state output unit 13 is provided with the measured value of the sensor corresponding to the state of the measurement target.

FIG. 5 is a flowchart showing a specific example of the processing of the patient / staff status output unit 13.

When in the standby state (step 5a), it receives the sensor measurement (step 5b). Next, the received measured value is converted into the patient / staff status according to the type of sensor (staff 5c). Then, the converted patient / staff status is output to the comparison unit 15, and the process returns to step 5a.

4. Countermeasure table holder The countermeasure table holding unit 14 is a database that stores a countermeasure table in which items such as sensor type, measurement status, countermeasure information, start condition and end condition of monitoring by the sensor are stored. FIG. 6 is a diagram showing a specific example of the countermeasure table.

5. Comparison section The comparison unit 15 compares the patient status or staff status output by the patient / staff status output unit 13 with the contents of the treatment schedule / implementation record table, and measures (nurse) defined in advance in the countermeasure table according to the comparison result. This is a program that calls for the implementation of (calling, calling to the patient, etc.) and instructing the alarm unit 16.

From the patient identification number and measurement time included in the patient status acquired from the patient / staff status output unit 13, refer to the treatment schedule / implementation record table of the patient, and the rest set for the patient for the relevant time zone. Take out the degree. Then, the degree of rest taken out is compared with the content of the patient state (rest on the bed, trying to get out of bed, etc.) output from the patient / staff state output unit 13, and if they do not match, they are defined in the countermeasure table. Call for the implementation of the measures taken and instruct the alarm unit 16.

For example, for a patient whose rest level is set to "rest on the bed" in the treatment schedule / implementation record table, if the content of the patient state output by the patient / staff status output unit 13 is "rest on the bed", a comparison is made. Part 15 does nothing. However, if the content of the patient status output by the patient / staff status output unit 13 is "trying to get out of bed", it is set in the nurse center of the ward where the patient is hospitalized or in the treatment schedule / implementation record table. Have the patient make a nurse call to the mobile terminal held by the nurse in charge during the time period.

On the other hand, for patients whose rest level is set to "free in the hospital" in the treatment schedule / implementation record table, the content of the patient status output by the patient / staff status output unit 13 is "trying to get out of bed". Even if there is, do nothing. However, if the patient's condition is "at the hospital gate" according to the measurement result of the camera, a nurse call is sent.

In this way, without setting various sensors for each patient, the patient status for each time zone set in the treatment schedule / implementation record table and the output of the patient / staff status output unit 13 based on the measurement results of the sensors. Countermeasure information such as a nurse call is automatically output according to the comparison result with the information.

In addition, when the content of the patient status, which is the output information of the patient / staff status output unit 13, is "accompanied by the staff", a nurse call is sent regardless of the rest level on the treatment schedule / implementation record table. It can be set not to. Similarly, if the output information of the patient / staff status output unit 13 is "falling" or "falling", the nurse call should be sent regardless of the patient's rest. Can be set to.

In addition, in the case of infusion, regular observation by staff is required. For example, in FIG. 3, the start condition is set to 30 minutes after the infusion start time specified in the order to monitor the presence or absence of the infusion start. Then, if the implementation record on the treatment schedule / implementation record table for this order is "instructed" and not "started" at that time, a warning is sent to the nurse in charge. For regular observation after the start of infusion (for example, every hour), the start condition is the treatment schedule / implementation record table, and the implementation record is "start", and the end condition is "start time + continuation of infusion". Time. " If the measurement result of the RFID installed on the bedside of the patient at the time specified by the start condition and the end condition is "more than 1 hour has passed since the last visit", a warning is sent to the nurse in charge.

In the comparison process in the comparison unit 15, the output result of the patient / staff status output unit 13 has changed from the previous output result for each patient and staff, or the current cell of the treatment schedule / implementation record table. It is sufficient to carry out when the value changes according to the passage of time and the output result of the patient / staff status output unit 13.

FIG. 7 is a flowchart showing a specific example of the comparison process regarding the patient state in the comparison unit 15. It should be noted that this process shall be performed for each patient.

When in the standby state (step 7a), the patient status is received from the patient / staff status output unit 13 (step 7b). Using the patient ID included in the patient status information as a key, the treatment schedule / implementation record table of the patient is acquired from the treatment schedule / implementation record unit 11 (step 7c). Next, the rest level of the patient in the time zone is obtained from the treatment schedule / implementation record table (step 7d). Next, the countermeasure table is acquired from the countermeasure table holding unit 14, and the corresponding measurement status is acquired from the countermeasure table using the sensor type and the rest level as keys (step 7e).

Next, the patient status acquired from the patient / staff status output unit 13 and the measurement status acquired from the countermeasure table are compared (step 7f). If the patient state and the measurement state do not match, the call / alarm unit 16 is instructed to output the call / alarm according to the measures defined in the countermeasure table (step 7g), and the process returns to step 7a. On the other hand, when the patient state and the measurement state match, the output instruction to the call / alarm unit 16 is not performed, and the process returns to step 7a.

FIG. 8 is a flowchart showing a specific example of processing related to the staff state in the comparison unit 15. It should be noted that this process shall be performed for each patient.

After a certain period of time has passed in the standby state (step 8a), the patient's treatment schedule / implementation record table is acquired from the treatment schedule / implementation record holding unit 14 (step 8b). Next, from the patient's treatment schedule / implementation record table, the implementation details and implementation records of treatment, treatment, drugs, tests, etc. in the current time zone are extracted (step 8c). Next, the measurement status of the treatment, treatment, drug, test, etc. extracted in step 8c is acquired from the countermeasure table (step 8d). Next, it is determined whether or not the implementation record and the measurement state of the countermeasure table match (step 8e). Here, if the implementation record and the measurement status of the countermeasure table do not match, a call is made to implement the countermeasure defined in the countermeasure table / the alarm unit 16 is instructed (step 8f), and the process returns to step 8a. On the other hand, if the implementation record and the measurement status of the countermeasure table match, the call / alarm unit 16 is not instructed, and the process returns to step 8a.

6. Call / alarm section The call / alarm unit 16 is based on the instruction information from the comparison unit 15 for various terminals 2 such as the PC of the nurse center, the PDA and PHS carried by the nurse, and the terminal installed on the bedside of the patient. It is a program that calls and alerts. Examples of the method of calling / warning include a warning sound such as a nurse call, lighting of a warning light, and message display.

As described above, the patient / staff management device 1 compares the treatment schedule / execution record table held by the treatment schedule / execution record holding unit 11 with the patient / staff status output from the sensor measurement value, so that each patient can be compared. We can flexibly respond to assessments made, orders exchanged between staff, and clinical pathways for each disease.

In addition, since the patient / staff management device 1 is provided with the countermeasure table holding unit 14 that holds the countermeasure table, it is possible to easily compare the recorded contents of the treatment schedule / implementation record table with the sensor measurement values, and various sensors. It is possible to change the operation for the above by changing the definition of the countermeasure table without modifying the program.

(Embodiment 2) The patient / staff management system in the present embodiment does not include the countermeasure table holding unit 14, and does not use the countermeasure table for the comparison process in the comparison unit 15. Since the other configurations are the same as those in the first embodiment, the description thereof will be omitted, and the different operations of the comparison unit 15 will be described with reference to the drawings.

FIG. 9 is a flowchart showing a specific example of the comparison process regarding the patient state in the comparison unit 15. It should be noted that this process shall be performed for each patient.

When in the standby state (step 9a), the patient status is received from the patient / staff status output unit 13 (step 9b). Using the patient ID included in the patient status as a key, the treatment schedule / implementation record table is acquired from the treatment schedule / implementation record unit 11 (step 9c). Next, the degree of rest in the relevant time zone is obtained from the treatment schedule / implementation record table (step 9d). The patient status obtained is then compared to rest (step 9e). If the patient's condition and rest level do not match, call / alarm unit 16 to the mobile terminal held by the nurse in charge of the patient at the time of the treatment schedule / implementation record table, or to the nurse center in the ward in charge. Instruct to make a nurse call (step 9f) and return to step 9a. On the other hand, when the patient's condition and the rest level match, the process returns to step 9a without instructing the call / alarm unit 16 to make a nurse call.

FIG. 10 is a flowchart showing a specific example of processing related to the staff state in the comparison unit 15. It should be noted that this process shall be performed for each patient.

After a certain period of time has passed in the standby state (step 10a), the patient's treatment schedule / implementation record table is acquired from the treatment schedule / implementation record holding unit 14 (step 10b). Next, the implementation details and implementation records of treatments, treatments, drugs, tests, etc. in the current time zone are extracted from the patient's treatment schedule / implementation record table (step 10c).

Next, it is determined whether the treatment schedule and the implementation record match (step 10d). Specifically, whether or not the implementation record violates the drug administration time, test implementation time, patrol interval, etc. specified on the treatment schedule / implementation record table beyond a certain range is determined by order, clinical path, etc. Judgment is made based on the process map.

Here, if the treatment schedule and the implementation record do not match, the call / alarm unit 16 is instructed to send a nurse call (step 10e), and the process returns to step 10a. On the other hand, if the treatment schedule and the implementation record match, the call / alarm unit 16 is not instructed to make a nurse call, and the process returns to step 10a.

As described above, when the patient / staff management device 1 does not have the countermeasure table holding unit 14 for holding the countermeasure table, the comparison unit 15 needs to set various conditions to make a judgment. There is an advantage that implementation becomes easy when there are few methods.

The present invention is not limited to the above embodiment, and can be variously modified and implemented within the scope of the technical idea of the present invention.

<figref num="1">The figure which shows the whole structure example of the patient / staff management system which concerns on Embodiment 1 of this invention.</figref><figref num="2">It is a figure which shows the specific example of the treatment schedule / execution record table which concerns on Embodiment 1 of this invention.</figref><figref num="3">The flowchart which shows the specific example of the process of the treatment schedule / execution recording unit 12 which concerns on Embodiment 1 of this invention.</figref><figref num="4">The figure which shows the specific example of the output content of the patient / staff state output unit 13 with respect to the measured value of the sensor 3 which concerns on Embodiment 1 of this invention.</figref><figref num="5">The flowchart which shows the specific example of the processing of the patient / staff state output unit 13 which concerns on Embodiment 1 of this invention.</figref><figref num="6">The figure which shows the specific example of the countermeasure table which concerns on Embodiment 1 of this invention.</figref><figref num="7">The flowchart which shows the specific example of the process of the comparison part 15 which concerns on Embodiment 1 of this invention.</figref><figref num="8">The flowchart which shows the specific example of the process of the comparison part 15 which concerns on Embodiment 1 of this invention.</figref><figref num="9">The flowchart which shows the specific example of the process of the comparison part 15 which concerns on Embodiment 2 of this invention.</figref><figref num="10">The flowchart which shows the specific example of the process of the comparison part 15 which concerns on Embodiment 2 of this invention.</figref>

Code description

1 ... patient / staff management device, 2 ... terminal, 3 ... sensor, 4 ... network 11 ... Treatment schedule / implementation record holding section, 12 ... Treatment schedule / implementation record section, 13 ... Patient / staff status output section, 14 ... Countermeasure table holding section, 15 ... Comparison section, 16 ... Call / alarm section.