C.U.T. (Chirurgia d’Urgenza Tetraedrica): a Data Base for a high quality urgent surgery

Abstract

C.U.T. (Chirurgia d’Urgenza Tetraedrica = Tetrahedron Urgent Surgery) is the Data Base programmed and utilized since November 2004 in a “Urgent Surgery Unit” at high turnover of patients and surgeons. The aim of C.U.T. was to contribute in the management of delivery risk, to facilitate medical work, to improve assistential quality.

Utilizing a “tetrahedron logic”, a “decisional medical dynamic tetrahedron” has been obtained. As indicated on the vertices of this dynamic tetrahedron, the four main parameters are: “problem”, “substratum”, “state”, “decision”. These parameters are the dynamic variables of the four logically deducted files of the Data Base: “In-patients”, “Patient’s chronology”, “Discharged patients”, “Interventions”.

The new informations are introduced by a surgeon in the general prospect of the ward “In-patients” and are automatically imported in the file “Patient’s chronology”. The file “Patient’s chronology” offers the cronological sequence of checkdecisions for every single patient. The file “Discharged patients” stores the data of patients discharged and eliminated from the impatient’s prospect. It compiles automatically a dimission letter and aids in the the compilation of the dimission schedule by the informations received from two files storing the ICD9cm codification of diagnosis and interventions. The file “Interventions” includes three different formats respectively allowing description, catalogation and clinical-iconografic storing. The latter format is also utilized for a “problem centered” medical teaching.

This Data Base resulted to be functional, simple, useful, accepted, easly modifiable and was able to prevent delivery risk, to facilitate medical work, to improve assistential quality.