Nursing record innovations aimed at harmonizing structured clinical knowledge among doctors and nurses

Satoko Tsuru, Tetsuro Tamamoto, Hitoshi Furuya, Akihiro Nakao, Mari Fukuyama, Kouichi Tanizaki, Naohisa Yahagi

Research output: Chapter in Book/Report/Conference proceedingConference contribution

4 Citations (Scopus)


Hospitalization expenses account for a high proportion of national medical care expenditure in Japan. In 2015, the total national medical care expenditure in Japan was 42.4 trillion yen, and hospitalization expenses were 15.6 trillion yen (36.8%). Therefore, it is necessary to reduce hospitalization expenses. The labor cost of physicians and nurses accounted for about 1/3rd of all expenditure of general hospitals in 2015. Moreover, the personnel cost of nurses accounted for about 1/5th of all expenditure, indicating that it has a marked impact on hospital management. Nurses spend a lot of time completing descriptive records; however, the quality of such records is poor. It is necessary to improve nurse's records to make them highly accessible and reduce the amount of time nurses spend producing records. The objective of this study was to improve the processes underlying record-keeping by nurses in order to harmonize structured clinical knowledge among doctors and nurses. We created 778 Patient Condition Adaptive Path System (PCAPS) items, covering all of the clinical departments that were registered for the PCAPS content master. The resultant masters will be standardized by sharing them with hospitals that adopt the “Team Compass” application. We were able to summarize all of the information in clinical progress sheets because we could link the information described in electronic medical records with that described in Team Compass. Therefore, it became easy to collect information by linking information about clinical orders. The system also made it possible for foundational nursing plans to be created in collaboration with doctors instead of being developed by nurses alone because it allowed information regarding patients' problems, the clinical process, and observation selection to be shared smoothly with doctors. We implemented Team Compass in May 2019. On the first day, PCAPS-based care pathways were used to treat 580 of 623 inpatients. Approximately 4,000 patients were treated using this system from May to August 2019. No major problems have arisen since the implementation of Team Compass.

Original languageEnglish
Title of host publicationDigital Personalized Health and Medicine - Proceedings of MIE 2020
EditorsLouise B. Pape-Haugaard, Christian Lovis, Inge Cort Madsen, Patrick Weber, Per Hostrup Nielsen, Philip Scott
PublisherIOS Press
Number of pages5
ISBN (Electronic)9781643680828
Publication statusPublished - 2020 Jun 16
Externally publishedYes
Event30th Medical Informatics Europe Conference, MIE 2020 - Geneva, Switzerland
Duration: 2020 Apr 282020 May 1

Publication series

NameStudies in Health Technology and Informatics
ISSN (Print)0926-9630
ISSN (Electronic)1879-8365


Conference30th Medical Informatics Europe Conference, MIE 2020


  • Digitalization
  • Healthcare
  • Quality management
  • Structured clinical knowledge

ASJC Scopus subject areas

  • Biomedical Engineering
  • Health Informatics
  • Health Information Management


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