Does extended CPOE use reduce patient length of stay?

Romanow, Darryl; Rai, Arun; Keil, Mark; Luxenberg, Steven

doi:10.1016/j.ijmedinf.2016.09.012

Cited by 14 publications

(9 citation statements)

References 34 publications

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“…In addition, greater and more accurate communication amongst healthcare professionals has been demonstrated. [1][2][3][4][5] Despite this, minimal research has focussed on the impact of these electronic systems on the people and processes required to realise the improvements in patient care such as therapeutic drug monitoring (TDM) and the role of the pharmacist within the TDM process. 6 The ieMR cites benefits of delivering an integrated suite of digital services that improve safety, efficiency and quality in clinical workflow processes.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

The impact of an electronic hospital system on therapeutic drug monitoring

et al. 2021

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What is known and objective: Australian hospitals have undergone a transformation with both a review and expansion of traditional roles of healthcare professionals and the implementation of an ieMR. The implementation of an ieMR brings large scale organizational change within the health system especially for staff with direct patient contact. This is changing the future of healthcare and the roles of healthcare professionals. There is minimal research on the impact of these electronic systems on the

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Section: What Is K Nown and Objec Tivementioning

confidence: 99%

The impact of an electronic hospital system on therapeutic drug monitoring

et al. 2021

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“…Computerized physician order entry (CPOE) has been introduced as a process of medical orders in an electronic way to replace the traditional paper-based lengthy system which with many clinical errors. CPOE has improved coordination in clinical processes effectively in reducing length of stay and related medication errors (Romanow, Rai, Keil, & Luxenberg, 2017). On February 17, 2009, with the aim of providing better and more secure health care to overall population, the Health Information Technology for Economic and Clinical Health Act (HITECH) was introduced under the American Recovery and Reinvestment Act (ARRA) (Recovery Act, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Another study has reported that about 62% large, 47% medium, and 38% small hospitals have adopted CPOE for medications in 2012 (Nuckols et al, 2014). In addition, the implication of Meaningful Use has been gone up to 95% of Medicare eligible hospitals until 2015 (Romanow, Rai, Keil, & Luxenberg, 2017).…”

Section: Introductionmentioning

confidence: 99%

The Implementation of Computerized Physician Order Entry in the Intensive Care Unit

Zhang¹

2021

ijSciences

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Computerized physician order entry (CPOE) has been known as a process of physician orders in an electronic way instead of the traditional paper-based system. CPOE has been included as one of core objectives in the term "Meaningful Use" by Centers for Medicare and Medicaid Services. The U.S. Department of Health and Human Services Office of Inspector General reported 180,000 deaths in the United States in 2008 due to medication errors. The Institute of Medicine reported about 450,000 preventable adverse drug effects which costed additional $3.5 billion. On average, 1.7 medication errors per day and 74.5% errors in parenteral drugs administration were reported in the intensive care unit (ICU). The purpose of this research was to examine the benefits, barriers and risks of CPOE adoption in different ICUs. The methodology for this study was a literature review. Research was conducted by collecting scholarly online database and government websites. On one hand, CPOE could provide patient"s health record regardless of time and place, alerts in drug interactions, and suggest in clinical decisions in ICUs. CPOE could also reduce medication errors and adverse drug events significantly. On the other hand, CPOE could provide better solutions if it would be used with real-time conversation and as per workflow of ICUs. In addition, user satisfaction and sufficient training, were important factors in implementing CPOE with more successful and desired outcomes.

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“…With the increasing number of commercial CPOE systems available on the market, various evaluations have been carried out to identify their respective impacts on clinical efficiency and effectiveness, particularly in regards to errors and patient safety. There have been encouraging findings to support the implementation of CPOE in reducing the hospital length of stay [2,3], reducing medication errors [4], simplifying and optimizing nursing services [5], decreasing the risk of preventable harm [6], enhancing nurse-physician communication [7], and improving patient outcomes [8]. On the other hand, some drawbacks have been identified such as burdens on providers due to the extra time and effort needed [9], and suggestions for better integration into clinical practice have also been made [10].…”

Section: Introductionmentioning

confidence: 99%

Impact of IPMOE on nursing tasks in the medical ward: A time-motion study

Leung¹,

Chan

Wong

et al. 2018

International Journal of Nursing Sciences

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Introduction The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital, Hong Kong. It was a local developed close-loop system including prescription, dispensing and administration modules. Evaluation on its impact on nursing tasks would be important for practice improvement and subsequent system enhancement. Objective The study was conducted to quantify the nursing times across medication-associated tasks for paper-based MAR and computer-based IPMOE, including change in the tasks and time patterns before and after IPMOE implementation. Methods This was a prospective observation study in medical wards before (Jan 2014–Jun 2014) and after (Mar 2015–Jun 2015) the implementation of IPMOE. We conducted 8-hr observation studies of individual nurses with a customized application to time various pre-categorized nursing tasks. Statistical inferences and interrupted time series analysis was performed to identify the change in the intercept and trends over time after implementation. Result The average number of medication-related tasks was significantly reduced from 61.07 to 29.81, a reduction of 31.26 episodes per duty ( P < 0.001, 95% CI 22.9–39.63). The time for the medication-related tasks was reduced from 32 min (SD = 21.57) to 26.57 min (SD = 11.35) and the medication administration time increased from 37.93 min (SD = 14.78) to 44.37 min (SD = 19.45), but there was no overall significant difference in the time spent on each duty ( P = 0.315) between the two groups. An improving trend in the delayed effect was observed ( P = 0.03), which indicated a run-in period for new application was needed in clinical setting. Conclusion Our study had shown the time motion observation could be applied to measure the impact of the IPMOE in a busy clinical setting. Through classification of activities, validation, objective measurement and longitudinal evaluation, the method could be applied in various systems as well as different clinical settings in measure efficiency.

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Does extended CPOE use reduce patient length of stay?

Cited by 14 publications

References 34 publications

The impact of an electronic hospital system on therapeutic drug monitoring

The impact of an electronic hospital system on therapeutic drug monitoring

The Implementation of Computerized Physician Order Entry in the Intensive Care Unit

Impact of IPMOE on nursing tasks in the medical ward: A time-motion study

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