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Physician Order Entry (physician + order_entry)
Kinds of Physician Order Entry Selected AbstractsComputerized Physician Order Entry with Clinical Decision Support in the Long-Term Care Setting: Insights from the Baycrest Centre for Geriatric CareJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Paula A. Rochon MD Although computerized physician order entry (CPOE) has been successfully implemented in many acute care hospitals, few descriptions of its use in the long-term care (LTC) setting are available. This report describes the experiences of one LTC facility in developing and implementing a CPOE system with clinical decision support (CDS). Even when a facility has the necessary resources and "institutional will," many challenges are associated with the implementation of this application. The system was designed to meet the needs of healthcare providers in the LTC setting, in particular by informing prescribing decisions, reducing the frequency of prescribing and monitoring errors, and reducing adverse drug event rates. Based on experience adopting this technology early, 10 insights are offered that it is hoped will assist others who are considering the implementation of CPOE systems with CDS in the LTC setting. [source] Computerized physician order entry (CPOE) system: expectations and experiences of usersJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2010Jasperien E. Van Doormaal PharmD Abstract Objectives, To explore physicians' and nurses' expectations before and experiences after the implementation of a computerized physician order entry (CPOE) system in order to give suggestions for future optimization of the system as well as the implementation process. Method, On four internal medicine wards of two Dutch hospitals, 18 physicians and 42 nurses were interviewed to measure expectations and experiences with the CPOE system. Using semi-structured questionnaires, expectations and experiences of physicians and nurses with the CPOE system were measured with statements on a 5-point Likert scale (1 = completely disagree, 5 = completely agree). The percentage respondents agreeing (score of 4 or 5) was calculated. Chi-squared tests were used to compare the expectations versus experiences of physicians and nurses and to assess the differences between physicians and nurses. Results, In general, both physicians and nurses were positive about CPOE before and after the implementation of this system. Physicians and nurses did not differ in their views towards CPOE except for the overview of patients' medication use that was not clear according to the nurses. Both professions were satisfied with the implementation process. CPOE could be improved especially with respect to technical aspects (including the medication overview) and decision support on drug,drug interactions. Conclusion, Overall we conclude that physicians and nurses are positive about CPOE and the process of its implementation and do accept these systems. However, these systems should be further improved to fit into clinical practice. [source] Methodology for evaluating physician order entry (POE) implementationsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2003Glen Geiger MD CM MASc BASc FRCPC Abstract The body of physician order entry (POE) implementations literature uses statistical evaluation methods to demonstrate changes in specified variables after POE implementation. To understand and manage the holistic impact of POE on the health care institution, a methodology that utilizes feedback to guide the POE implementation towards the satisfaction of stakeholder objectives is presented. Stakeholders jointly define quantitative and qualitative metrics for their objectives, establish target value vectors for the metrics that represent acceptable implementation outcomes and specify evaluation milestones. These are used to compare pre- and post-POE implementation clinical performance, enabling a socio-technical feedback,improvement cycle. A case study is provided to illustrate how the methodology is being used at Sunnybrook and Women's College Health Science Centre in Toronto, Canada. [source] Universal acceptance of computerized physician order entry: What would it take?JOURNAL OF HOSPITAL MEDICINE, Issue 4 2006Eric G. Poon MD [source] The relationship between computerized physician order entry and pediatric adverse drug events: a nested matched case-control study,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 8 2009Feliciano Yu MD, MSPH Abstract This study assesses the impact of computerized physician order entry (CPOE) implementation in pediatric hospitals on reported adverse drug events. Using a nested matched case-control design; we linked CPOE implementation information from the health information management systems society analytics database with reported adverse drug event (ADE) from the national association of children's hospitals and related institutions case mix comparative data program. Differences were examined using univariate and multivariate conditional logistic regression analyses. Patients from CPOE hospitals were more frequently seen in larger hospitals have more co-morbidities than those from non-CPOE hospitals. When matched by admitting diagnosis, age, gender and race, ADE cases were associated with more reported co-morbidities, and were reported less frequently in hospitals with CPOE. Patients from hospitals without CPOE were 42% more likely to experience reportable ADE after adjusting for the presence of co-morbidities. In conclusion, we found significant beneficial associations between reportable ADE and CPOE adoption in a representative sample of pediatric hospitals. Copyright © 2009 John Wiley & Sons, Ltd. [source] Rural Hospital Patient Safety Systems Implementation in Two StatesTHE JOURNAL OF RURAL HEALTH, Issue 3 2007Daniel R. Longo ScD ABSTRACT:,Context and Purpose:With heightened attention to medical errors and patient safety, we surveyed Utah and Missouri hospitals to assess the "state of the art" in patient safety systems and identify changes over time. This study examines differences between urban and rural hospitals.Methods:Survey of all acute care hospitals in Utah and Missouri at 2 points in time (2002 and 2004). Factor analysis was used to develop 7 latent variables to summarize the data, comparing rural and urban hospitals at each point in time and on change between the 2 survey times.Findings:On 3 of the 7 latent variables, there was a statistically significant difference between rural and urban hospitals at the first survey, with rural hospitals indicating lower levels of implementation. The differences remained present on 2 of those latent variables at the second survey. In both cases, 1 of those variables was computerized physician order entry (CPOE) systems. Rural hospitals reported more improvement in systems implementation between the 2 survey times, with the difference statistically significant on 1 of the 7 latent variables; the greatest improvement was in implementation of "root cause analysis."Conclusions:Adoption of patient safety systems overall is low. Although rates of adoption among rural versus urban hospitals appear lower, most differences are not statistically significant; the gap between rural and urban hospitals relative to quality measures is narrowing. Change in rural and urban hospitals is in the right direction, with the rate of change higher in rural hospitals for many systems. [source] The impact of computerised physician order entry on prescribing practices in a cardiothoracic intensive care unit,ANAESTHESIA, Issue 2 2010J. Ali Summary This prospective, time series, cross-sectional study was designed to compare the quality of handwritten vs computerised prescriptions in a tertiary 25-bedded cardiothoracic intensive care unit. A total of 14 721 prescriptions for 613 patients were analysed over three periods of investigation: 7 months before; and 5 and 12 months after implementation of a clinical information system with computerised physician order entry capability. Errors in prescribing were common. Only (53%) of handwritten charts analysed had all immediate administration drugs prescribed correctly. Errors included omission of route 81 (8.0%), date of prescription 78 (7.7%), and time to be given 255 (25.2%), and 119 (11.7%) had no dose or an incorrect dose prescribed. All errors of completeness were abolished following implementation. The computerised system led to a significant improvement in prescribing safety, in a clinical area previously highlighted as having a high rate of adverse drug errors. Legibility, completeness and traceability are no longer possible sources of medication errors. [source] | ||||||||||