Homegrown System Research Articles

An Essay on the Potential for Successful Adoption of Quality Assurance Practices at Ispahani Islamia Eye Institute and Hospital

Quality Management Systems (QMSs) have become a mainstay in today’s industries, whether it is defense, frozen food manufacturing or healthcare. These systems, such as ISO, can be acquired and adopted after audits by a certifying body. These audits only check current compliance and not current performance. Only a minimum set of requirements are evaluated in order to gauge eligibility. However, there is no formal investigation into whether an organization can actually manage to successfully implement a QMS, whether ISO or any home grown system for that matter. Quality Management Systems are not silver bullets. They can only work when the organization as a whole is willing to accept it and more importantly has the knowhow, skills and intention to implement it. Implementing a QMS, when there is a lack of readiness to do so, will cause myriad troubles for any organization. This study focuses primarily on how to assess whether an organization, namely Ispahani Islamia Eye Institute and Hospital, has the capability or ‘potential’ to successfully implement a QMS. The study identifies six key elements that are crucial prerequisites for successful QMS adoption and uses these key elements to develop a questionnaire based tool for numerically measuring Islamia’s potential to successfully implement and adopt a QMS. The method will be developed in such a way so as to be meaningful for other organizations in general and across multiple industries.

Preparation is Key: Lessons Learned from an ERM System Implementation

In 2001, the University of North Texas (UNT) Libraries developed their own electronic resource management (ERM) system to track their online resources and contracts. Over the past decade, the programming and upkeep for the homegrown system had become too much of a burden, and the decision was made to move to a vendor-supported ERM system. In the summer of 2012, UNT began the implementation of Innovative’s ERM module. This presentation covered the steps involved in that implementation and the lessons learned on how best to prepare for a radical shift in workflows and procedures.

Impact of computerized physician order entry (CPOE) on PICU prescribing errors

Dear Editor, Prescribing errors frequently occur in pediatric intensive care units (PICUs), for which both lowand high-technology solutions have been evaluated [1, 2]. Computerized physician order entry (CPOE) systems, including clinical decision support (CDS), offer the potential to reduce prescribing error rates in PICUs, but only if well designed and implemented [2–4]. We examined frequency, types, and risk factors of PICU prescribing errors in relation to use of CPOE. This prospective study was performed in a 14-bed PICU of a tertiary children’s hospital using a homegrown CPOE system since 2001. Contemporaneously, orders could be handwritten, allowing comparison. Medication orders of all patients admitted between February 2008 and December 2010 were reviewed for prescribing errors. The study was performed in accordance with the institutional review board guidelines. A total of 718 patients were included with 22,280 medication orders, of which 15,136 (68 %) were handwritten and 7,144 (32 %) CPOE. Omission rates were 66 % in handwritten versus 24 % in CPOE orders. Writing by hand was a strong risk factor for omissions, but CPOE did not reduce the error rate to zero. This was mainly due to the possibility to enter free text into the CPOE system. Because an order has to be complete for the purpose of dose checking, we state that free text entry should be minimized. In our study 12,879 orders were complete and could be reviewed for dosing errors (i.e., dose more than 10 % below or above guideline therapeutic range). Dosing error rates were 21 % in handwritten and 21 % in CPOE orders. Strikingly, 81 % of these dosing errors were more than 10 % below rather than above the therapeutic range, as shown in Fig. 1, and mainly concerned underdosing of antibiotics and analgesics for example. Kadmon et al. [4] already advocated that CPOE in a PICU must be accompanied by CDS that checks medication overdosing. We add that prevention of underdosing should also be incorporated. Associations between dosing errors and covariates related to the patient, order, or drug were studied using logistic regression analysis with forward selection. Intermittent dosing was the strongest risk factor for dosing errors [ORadjusted 5.6 (95 % CI 3.2, 9.8)]. Additionally, all routes of administration related to intermittent dosing, e.g., oral, rectal, and pulmonary, were significantly associated with omissions and dosing errors compared to the parenteral route. Currently though, CPOE/CDS development for PICUs mainly aims to support fast, correct, and easy ordering of continuous infusions [5]. We add that support for intermittent dosing regimens is also required. In conclusion, we identified three important additional requirements for CPOE/CDS to further prevent PICU prescribing errors: (1) minimization of any free text entry that could limit CDS for dose calculation and/or dose

Optimizing Electronic Reserves Processes With Ares

The electronic course reserves service at the University of Nevada, Reno became increasingly popular each year following its launch in 2000. In 2005, a homegrown system was developed to better manage the service. By 2010, the homegrown system was showing its age, and the workflow became unmanageable following deep budget cuts. In order to streamline processing and provide a superior user experience, the e-reserves department transitioned to Ares in the summer of 2011. This case study examines the decision to purchase e-reserves software and the steps taken to ensure a successful transition for library staff as well as faculty and student users of e-reserves.

Libraries and electronic health records: focus on “evidence” as part of treatment and care, not on “the library”

Libraries and electronic health records: focus on “evidence” as part of treatment and care, not on “the library”

E-Matrix—Choosing to Grow Your Own Electronic Resource Management System

Even with commercial options now available, the North Carolina State University (NCSU) Libraries has chosen to continue developing a homegrown electronic resource management (ERM) system, E-Matrix. This contributor provides a brief description of E-Matrix and outlines the reasons NCSU chose not to go with a commercial product. He also discusses changes to technical services workflows and presents lessons learned by NCSU during the development process. Meyer offers recommendations to consider when implementing either a homegrown or commercial ERM system.

E-Matrix—Choosing to Grow Your Own Electronic Resource Management System

Even with commercial options now available, the North Carolina State University (NCSU) Libraries has chosen to continue developing a homegrown electronic resource management (ERM) system, E-Matrix. This contributor provides a brief description of E-Matrix and outlines the reasons NCSU chose not to go with a commercial product. He also discusses changes to technical services workflows and presents lessons learned by NCSU during the development process. Meyer offers recommendations to consider when implementing either a homegrown or commercial ERM system.

Editorial: I Keep My Eyes Wide Open All the Time

Editorial: I Keep My Eyes Wide Open All the Time

Creating, Designing, and Building an Electronic Reserve System

The purpose of this article is to provide the basic requirements and design for the in-house development of an electronic reserve system and to identify some of the pros and cons of implementing a homegrown system. The requirements contain enough technical detail to give the reader guidance for building a homegrown electronic reserve system, but are described in layman's terms so as not to turn this article into a technical specification manual. These requirements can alternately aid in evaluating third party stand-alone electronic reserve systems and integrated electronic reserve system modules from library automation vendors, or they can serve as a basis for developing a request for proposals (RFP). This article does not address image or text capture hardware, software, or workflow processes needed to populate an electronic reserve system. Instead, it is concerned with the database structure needed to support an electronic reserve system, the system architecture that enables the delivery of digitized course readings to the end user, the user interface that provides access to those images, and the copyright compliance mechanisms. The Web Course Reserve System described in this article is available as a prototype at the following Web site: http://www.uni.edu/∼wynstra/wcrs. This Web site includes scripts and design documents that can be used for recreating this prototype if the reader desires to use it as a starting point for local development.

Remembrances of Bob Paige

I first met Bob in 1969. He had just come to New York to join the systems staff at the Courant Institute. We had a CDC6600 back then, but our computing services were in the dark ages. Bob was hired to debug a homegrown time-sharing system that didn’t work. He turned out to be a perfect hire; Bob thoughtfully discarded the code and built the system afresh. Our acquaintance was casual for years. I was just aware that he was an outstanding systems implementor who was knowledgeable about music and film. His name also appeared at the top of the Institute chess ladder. That was no mean feat; the Institute had a number of Russian students back then, and most were strong players. Time passed, and our relationship grew. But we really got to know each other after we both became faculty members at NYU. Somehow, we started having discussions of all sorts: computer science, math, advising students, programming languages, research, chess, parenthood, children and family, growing up, music, film, restaurants, life, and doing the right thing. Whatever the topic, Bob always had something insightful to say. I have to confess that Bob was a hard study. His interests were broad, and he often used the power of metaphor and literary allusion to make a point. I recall several discussions where I struggled to keep up with what he was saying. As I came to understand over time, Bob had extremely high standards, and it is fair to suggest that there were times when he himself did not meet them. This was never a reason for him to give up, but rather to work harder. For example, Bob had felt that his mathematics background was inadequate, so he took some math classes. I never completely understood just why he thought that mathematics was so important to his research, but it is fair to say that mathematical ideas and paradigms influenced his work. Bob was especially proud of his programming version of finite differencing, which he invented to maintain program invariants and to generate efficient code. Very few systems researchers have as mathematical and high a level perspective about programming languages as Bob had. His was visionary. His research pursued very long term problems that almost no one thought could be solved. He started as an army of one, and built a system that semiautomatically transforms programs with great power and efficiency. This work covered many areas of expertise, and no matter what was needed, Bob stood ready to accept the challenges. It is no accident that a number of basic algorithms and algorithmic ideas came out of his research. And Bob carried this intensity and passion into his teaching and advisement. I think it fair to say that Bob caringly enriched his students with his uniquely big-picture approach to language research. You can tell a great deal about Bob from his students. I do not think anyone in our department ever managed to attract a brighter group than Bob’s. Jeff Ullman once commented that although he (Jeff) had had a very large number of students, there were very few for whom he can claim to have made a major impact. Jeff was actually commenting about how

Self-Serve Electronic Reserves

This article describes the current workflow procedures and tools that have allowed for a dramatic increase in the number of electronic reserves processed while only requiring minimal staffing increases. This homegrown system meets the demand for rapid scanning requests, easy entry into the library integrated library system, and the transfer of some scanning to the academic departments. This article describes how one small, private liberal arts college is coping with providing timely access to online reserve materials in a manner consistent with current service and copyright principles, while incurring minimal staffing impacts.

Creation and Management of a Home-Grown Electronic Reserves System at an Academic Library: Results of a Pilot Project

This article discusses the development of an electronic reserves software system and related administrative issues (e.g., staffing); technical and work flow issues; education and training of users, faculty, and staff; and the assessment of processes. It concludes with advice from the findings of the pilot project for other libraries building electronic reserves programs.

Europe's future mobile telephony system

Building on the huge success of its homegrown cellular system, Europe is planning a next-generation wireless system to handle data as well as voice, and-it is hoped-lay the foundation for universal roaming. The system being developed in the framework of the European Telecommunications Standards Institute (ETSI) is called UMTS (Universal Mobile Telecommunication System). In parallel, the International Telecommunication Union, based in Geneva, is formulating IMT (International Mobile Telecommunications) 2000, which is to be a family of systems that will let users roam worldwide with the same handset, and which will include UMTS as a subset.

The Evolution of an Online Acquisitions System

About two years ago a home-grown online acquisitions system was developed and implemented at Pacific University. The program, written in BASIC for the Data General Nova Computer, perform sall the necessary functions such as ordering ,receiving, fund accounting, etc. Thisprogram was offered to the library community ,and about one hundred libraries from around the world have availed themselves of it.