Embedded Guideline Information without Patient Specificity in a Commercial Emergency Department Computerized Order‐entry System

Asaro, Phillip V.; Sheldahl, Amy L.; Char, Douglas

doi:10.1197/j.aem.2005.09.015

Cited by 22 publications

(20 citation statements)

References 41 publications

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“…Technology adaptation such as CPOE can be influenced by physician resistance (47), organisational factors (48), hospital characteristics regarding economic profile, poor integration into workflow (20,47), ownership and environmental factors such as competition and technology adaptation behaviour of neighbouring hospitals (49). In addition to these universal factors, the lack of healthcare workforce is the main problem in our health system.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness and Outcomes of Computerized Provider Order Entry in Emergency Care Deparment of Private Hospitals

Mumcu

Köksal²,

Şişman³

et al. 2013

MUSBED

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Özel hastane acil bakım kliniklerinde elektronik hekim orderlarının etkinliği ve çıktıları Amaç: Bu çalışmanın amacı acil bakım kliniklerinde elektronik hekim order girişinin etkinliği ve çıktılarını değerlendirmektir. Yöntem: Bu araştırmaya İstanbul'da hizmet veren 24 özel hastanenin acil bakım kliniklerinde çalışan 24 hekim ve 24 hemşire katıldı. Veriler elektronik hekim order girişinin etkinliği ve çıktılarına odaklanmış soruları içeren bir anket formu ile toplandı. Formda yer alan maddeler beşli likert ölçeği ile değerlendirildi. Bulgular: Hekim ve hemşirelerin, Etkinlik boyutuna ilişkin, "ilaç listesine ulaşım", "ilaç dozları ve reçeteler", "ilaç etkileşim uyarıları", "daha hızlı reçeteleme", "reçeteleme hatalarının azaltılması", "diğer sağlık çalışanları ile etkin iletişim kurulabilmesi", "kolay çalışabilme", "kolay yönetebilme", ve "zamandan tasarruf sağlanması" maddelerinden aldıkları puanlar benzerdir (p>0.05). "Reçeteleme için daha iyi yaklaşımdır" ifadesine verilen puan hekimlerde hemşirelere göre daha yüksek olduğu belirlendi (p=0.038). Ayrıca, hekim ve hemşirelerin Çıktı boyutuna ilişkin, "hasta güvenliğini sağlama", "verinin güvenilirliğini ve okunabilirliğinin artması" maddelerinden aldıkları puanların aynı olduğu görüldü (p>0.05). Sonuç: Elektronik hekim order giriş sistemi acil bakım kliniklerinde hekim ve hemşireler tarafından etkin bir şekilde kullanılmaktadır. Sistemin reçeteleme için daha iyi bir yaklaşım sağlaması hekimler için önemli bir faktördür. Acil bakım kliniklerinde, bu sistemin kullanımı hasta güvenliği ve sağlık hizmeti kalitesini artırmıştır. Anahtar sözcükler: Elektronik hekim order girişi, hekim, hemşireler, acil bakım kliniği ABS TRACTThe effectiveness and outcomes of computerized provider order entry in emergency care department of private hospitals Objective: The aim of the study was to compare the effectiveness and outcomes of computerized provider order entry (CPOE) between physicians and nurses in emergency care (EC) services. Methods: In this study, 24 physician and 24 nurses working as fulltime in EC services of private hospitals (n=24) were selected in Istanbul, Turkey. Data were collected by a multi-item questionnaire focused on effectiveness and outcomes of CPOE usage. Items were coded by 5-point Likert scale and compared among them. Results: No significant difference was found in score (OF) item effectiveness regarding "accessing list of medication", "dosages and prescriptions" "alerting drug interaction", "faster prescription" "reducing prescribing error", "providing effective communication with staffs", "easy working" and "easy managing", "allowing decision making" and saving time" between physician and nurses (p>0.05). However, significant difference was seen in score of "being better approach for prescribing" between physician and nurses (p=0.038). Almost similar scores were seen in items of outcomes regarding "achieving patient safety" and "increasing reliability and legibility of data" (p>0.05). Conclusions: Consequently, CPOE system was used effectively by phy...

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Section: Discussionmentioning

confidence: 99%

The Effectiveness and Outcomes of Computerized Provider Order Entry in Emergency Care Deparment of Private Hospitals

Mumcu

Köksal²,

Şişman³

et al. 2013

MUSBED

View full text Add to dashboard Cite

show abstract

“…15 The guidelines had a general two-page sheet that included four different risk categories of ACS, followed by three different two-to three-page orders for each of the different categories (high and intermediate risk were combined into one set). Default selection of a set was not supported, thus requiring each order to be individually selected.…”

Section: Discussionmentioning

confidence: 99%

“…16 Asaro et al found no improvement with compliance of ACS medications; the best compliance was noted in the original simple order sheet before any interventions. 15 They attributed the lack of improvement to limited functionality in the system and the fact that the CDSS relied on clinicians actively seeking it out through a number of information-only fields. These were rarely accessed, and the appropriate order sets for a particular at-risk group were only used 47% of the time.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13] Exclusive evaluation of written standing orders within the emergency department (ED) has been limited to use of preprinted order sheets that successfully improved management of septic shock 7 and reduced pediatric medication errors. 14 Numerous studies have examined computerized physician order entry (CPOE) and clinical decision support systems (CDSS) in emergency medicine [15][16][17][18][19][20] and other areas of medicine, 4,21 with mixed results. Although implementation of CPOE is a national high priority, 22 widespread use has been limited.…”

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confidence: 99%

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Impact of Human Factor Design on the Use of Order Sets in the Treatment of Congestive Heart Failure

Reingold¹,

Kulstad²

2007

Academic Emergency Medicine

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“…EMRs have also been shown to offer improved accessibility, legibility and flexibility as well as a potential for reduction in medication errors [4]. Additionally, clinical decision support (CDS) within EMRs can support adoption of clinical practice guidelines [5], particularly when guidance is customized to both the provider and the patient [6].…”

Section: Introductionmentioning

confidence: 99%

Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE

Shriner

Webber

2014

Appl Clin Inform

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KeywordsComputer provider order entry, clinical decision support, electronic medical record Summary Background: Many resident physicians have experienced transitioning from traditional paper documentation and ordering to an electronic process during their training. Objective: We sought to investigate the attitudes and perceptions of residents related to implementation of computer provider order entry (CPOE) and clinical decision support (CDS). Methods: Pediatric residents completed web-based surveys prior to CPOE implementation and at 6 months and 12 months after implementation. The survey assessed resident attitudes and perceptions related to CPOE and the use of CDS tools. Additionally, at 6 and 12 months, residents were asked how electronic medical record (EMR) resources might impact future career decisions. Results: Prior to CPOE implementation, 70% of residents were looking forward to CPOE, but 28% did not want to transition from paper ordering. At 12 months post-implementation, 80% of residents favored CPOE over paper ordering and only 3.33% wished to revert to paper ordering. Residents reported an increase in time needed to enter admission orders 6-months after CPOE implementation. By 12 months post-implementation, there was no significant difference in perceived time to complete admission orders when compared to pre-CPOE responses. Most residents (91.67%) identified that overall EMR resources were an important factor when considering future employment opportunities. The most important factors included the degree of EMR implementation, technology resources and the amount of support staff. The least important factors included patient portal access and which EMR product is used. Conclusions: Overall, residents demonstrated a preference for CPOE compared to traditional paper order entry. Many residents remained unaware of CDS tools embedded within CPOE at the 12 month follow-up, but a majority of residents did find them helpful and felt more knowledgeable about current guidelines. EMR resources, including degree of EMR implementation, technology resources and support staff are likely to be important factors as residents take future employment opportunities into consideration.

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Embedded Guideline Information without Patient Specificity in a Commercial Emergency Department Computerized Order‐entry System

Cited by 22 publications

References 41 publications

The Effectiveness and Outcomes of Computerized Provider Order Entry in Emergency Care Deparment of Private Hospitals

The Effectiveness and Outcomes of Computerized Provider Order Entry in Emergency Care Deparment of Private Hospitals

Impact of Human Factor Design on the Use of Order Sets in the Treatment of Congestive Heart Failure

Attitudes and Perceptions of Pediatric Residents on Transitioning to CPOE

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