Challenges associated with electronic ordering in the emergency department: A study of doctors' experiences

Fernando, Sanj; Georgiou, Andrew; Westbrook, Johanna I.

doi:10.1111/j.1742-6723.2009.01214.x

Cited by 9 publications

(5 citation statements)

References 24 publications

(25 reference statements)

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“…This is in keeping with in other studies of CPOE in acute care settings which have reported increases in timed processes in Emergency Departments (ED) following the implementation of CPOE, (14) with authors suggesting that the complexity of the acute environment makes them vulnerable to disruption following the introduction of any new service. (17) However, in the current study there was a progressive improvement in LTAT after CPOE implementation in both AMU, and Critical Care. Consequently, the median LTAT at 18 months after CPOE implementation was lower than it had in the prior period suggesting benefit in the long-term.…”

Section: Discussioncontrasting

confidence: 52%

“…processes in Emergency Departments (ED) following the implementation of CPOE, (14) with authors suggesting that the complexity of the acute environment makes them vulnerable to disruption following the introduction of any new service. (17) However, in the current study there was a progressive improvement in LTAT after CPOE implementation in both AMU, and Critical Care.…”

Section: Sub-section Sensitivity Analysis -Laboratory Turnaround Time...contrasting

confidence: 51%

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The Impact of Electronic Order Communications on Laboratory Turnaround Times in Acute Hospital Care

Gallier,

Zou,

Evison

et al. 2024

Preprint

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ObjectiveTo examine the impact of computerised physician order entry (CPOE) systems upon laboratory turnaround times (LTAT), namely the time from recording the collection of a blood sample to the results being reported, within a large acute hospital.Materials and methods1,810,311 blood samples taken between 1stJanuary 2014 and 31stDecember 2019 were included. Changes in LTAT over the 24 months pre- and 18 months post-CPOE implementation were analysed using a segmented regression approach. The primary analysis assessed the median LTAT across the whole hospital, with secondary analyses assessing subgroups defined by clinical settings.ResultsCPOE implementation was associated with a step-change reduction in the median LTAT of 31.7 minutes (95% CI: 25.5-37.9, p<0.001). This was sustained over eighteen months post- implementation of CPOE despite the number of samples increasing by an average of 31% in this post-implementation period. Analysis by broad clinical specialty found all subgroups of wards considered to have a significant reduction in LTAT post-CPOE, either in the form of a step-change reduction, or an increasing rate of change.Discussion and ConclusionThe implementation of CPOE within an acute hospital improves the average LTAT over a prolonged period, despite an increase in the number of samples collected. This could improve care efficiencies. Understanding the likely reduction in LTAT also provides information to support an economic evaluation of the implementation of such a system into a new setting.

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Section: Discussioncontrasting

confidence: 52%

Section: Sub-section Sensitivity Analysis -Laboratory Turnaround Time...contrasting

confidence: 51%

The Impact of Electronic Order Communications on Laboratory Turnaround Times in Acute Hospital Care

Gallier,

Zou,

Evison

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…But CPOE also has a downside if it is not well-matched to ED workflow and task responsibility. 27 It is the province of future studies to confirm that an EHR-enabled environment gives rise to the observed benefits and to determine the mechanism by which they occur. If the salutary effects of an EHR we found are confirmed, other frequently occurring chronic diseases should be studied to better characterize parameters that may make prior information especially useful or not.…”

Section: Future Study Considerationsmentioning

confidence: 99%

The impact of electronic health records on care of heart failure patients in the emergency room

Connelly

Park

et al. 2012

Journal of the American Medical Informatics Association

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“…Pathology laboratories need to be proactive in planning and implementation of these systems. The importance of building strong organizational links and relationships with the users of these systems is crucial to their success 13,16,17 …”

Section: Ordering Testsmentioning

confidence: 99%

International Council for Standardisation in Haematology (ICSH) recommendations for collection of blood samples for coagulation testing

Kitchen¹,

Adcock

Dauer³

et al. 2021

Int J Lab Hematology

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This guidance document has been prepared on behalf of the International Council for Standardisation in Haematology (ICSH). The aim of the document is to provide guidance and recommendations for collection of blood samples for coagulation tests in clinical laboratories throughout the world. The following processes will be covered: ordering tests, sample collection tube and anticoagulant, patient preparation, sample collection device, venous stasis before sample collection, order of draw when different sample types need to be collected, sample labelling, blood‐to‐anticoagulant ratio (tube filling) and influence of haematocrit. The following areas are excluded from this document, but are included in an associated ICSH document addressing processing of samples for coagulation tests in clinical laboratories: sample transport and primary tube sample stability; centrifugation; interfering substances including haemolysis, icterus and lipaemia; secondary aliquots—transport and storage; and preanalytical variables for platelet function testing. The recommendations are based on published data in peer‐reviewed literature and expert opinion.

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Challenges associated with electronic ordering in the emergency department: A study of doctors' experiences

Abstract: The implementation of electronic ordering has important implications for ED functioning and the delivery of patient care. The complexity of the ED makes it vulnerable to disruption caused by inadequate system design and ineffective channels of communication across the hospital.

Cited by 9 publications

References 24 publications

The Impact of Electronic Order Communications on Laboratory Turnaround Times in Acute Hospital Care

The Impact of Electronic Order Communications on Laboratory Turnaround Times in Acute Hospital Care

The impact of electronic health records on care of heart failure patients in the emergency room

International Council for Standardisation in Haematology (ICSH) recommendations for collection of blood samples for coagulation testing

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