Computerized Provider Order Entry and Patient Safety

2006 ◽  
Vol 53 (6) ◽  
pp. 1169-1184 ◽  
Author(s):  
Christoph U. Lehmann ◽  
George R. Kim
Keyword(s):  
Patient Safety ◽  
Order Entry ◽  
Computerized Provider Order Entry

scholarly journals The impact of computerized provider order entry on emergency department flow

CJEM ◽  
2016 ◽  
Vol 18 (4) ◽  
pp. 264-269 ◽  
Author(s):  
Andrew Gray ◽  
Christopher M.B. Fernandes ◽  
Kristine Van Aarsen ◽  
Melanie Columbus
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Improve Patient Safety ◽  
Patient Flow ◽  
Wait Time ◽  
Order Entry ◽  
Computerized Provider Order Entry ◽  
Left Without Being Seen ◽  
Before And After ◽  
The Impact

AbstractObjectivesComputerized provider order entry (CPOE) has been established as a method to improve patient safety by avoiding medication errors; however, its effect on emergency department (ED) flow remains undefined. We examined the impact of CPOE implementation on three measures of ED throughput: wait time (WT), length of stay (LOS), and the proportion of patients that left without being seen (LWBS).MethodsWe conducted a retrospective cohort study of all ED patients of 18 years and older presenting to London Health Sciences Centre during July and August 2013 and 2014, before and after implementation of a CPOE system. The three primary variables were compared between time periods. Subgroup analyses were also conducted within each Canadian Triage and Acuity Scale (CTAS) level (1–5) individually, as well as for admitted patients only.ResultsA significant increase in WT of 5 minutes (p=0.036) and LOS of 10 minutes (p=0.001), and an increase in LWBS from 7.2% to 8.1% (p=0.002) was seen after CPOE implementation. Admitted patients’ LOS increased by 63 minutes (p<0.001), the WT of CTAS 3 and 5 patients increased by 6 minutes (p=0.001) and 39 minutes (p=0.005), and LWBS proportion increased significantly for CTAS 3–5 patients, from 24.3% to 42.0% (p<0.001) for CTAS 5 patients specifically.ConclusionsCPOE implementation detrimentally impacted all patient flow throughput measures that we examined. The most striking clinically relevant result was the increase in LOS of 63 minutes for admitted patients. This raises the question as to whether the potential detrimental effects to patient safety of CPOE implementation outweigh its benefits.

scholarly journals Varying rates of patient identity verification when using computerized provider order entry

2020 ◽  
Vol 27 (6) ◽  
pp. 924-928
Author(s):  
Emilie Fortman ◽  
A Zachary Hettinger ◽  
Jessica L Howe ◽  
Allan Fong ◽  
Zoe Pruitt ◽  
...  
Keyword(s):  
Patient Safety ◽  
Eye Movements ◽  
Healthcare Systems ◽  
Simulated Patient ◽  
Physician Training ◽  
Order Entry ◽  
Identity Verification ◽  
Computerized Provider Order Entry ◽  
Process Verification

Abstract Objective We sought to determine rates of computerized provider order entry (CPOE) patient identity verification and when and where in the ordering process verification occurred. Materials and Methods Fifty-five physicians from 4 healthcare systems completed simulated patient scenarios using their respective CPOE system (Epic or Cerner). Eye movements were recorded and analyzed. Results Across all participants patient id was verified significantly more often than not (62.4% vs 37.6%). Vendor A had significantly higher verification rates than not; vendor B had no difference. Participants using vendor A verified information significantly more often before signing the order than after (88.4% vs 11.6%); there was no difference in vendor B. The banner bar was the most frequent verification location. Discussion Factors such as CPOE design, physician training, and the use of a simulated methodology may be impacting verification rates. Conclusions Verification rates vary by CPOE product, and this can have patient safety consequences.

Computerized Provider Order Entry and Patient Safety

2012 ◽  
Vol 59 (6) ◽  
pp. 1247-1255 ◽  
Author(s):  
Erika L. Abramson ◽  
Rainu Kaushal
Keyword(s):  
Patient Safety ◽  
Order Entry ◽  
Computerized Provider Order Entry

scholarly journals Computerized Provider Order Entry in Pediatric Oncology: Design, Implementation, and Outcomes

2011 ◽  
Vol 7 (4) ◽  
pp. 218-222 ◽  
Author(s):  
Allen R. Chen ◽  
Christoph U. Lehmann
Keyword(s):  
Patient Safety ◽  
Pediatric Oncology ◽  
Order Entry ◽  
Computerized Provider Order Entry

Implementation of computerized provider order entry required extensive customization but improved patient safety in a highly complex pediatric oncology environment.

scholarly journals Response to Medication Dosing Alerts for Pediatric Inpatients Using a Computerized Provider Order Entry System

2011 ◽  
Vol 02 (04) ◽  
pp. 522-533 ◽  
Author(s):  
L. Fabrizio ◽  
S.H. Shaha ◽  
S.K. Magid ◽  
S.L. Perlman
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Decision Support ◽  
Pediatric Patients ◽  
Clinical Decision ◽  
Hospitalized Children ◽  
Order Entry ◽  
Computerized Provider Order Entry ◽  
Special Surgery ◽  
Hospital For Special Surgery

Summary Objective: Medication dosing errors are of particular concern in hospitalized children. Avoidance of such errors is essential to quality improvement and patient safety. Computerized provider order entry (CPOE) systems with clinical decision support (CDS) have the potential to reduce medication errors. The objective of this study was to evaluate provider response to the dosing alerts in a CPOE system with CDS for pediatric inpatients and to identify differences in provider response based on clinician specialty. Patients and methods: We conducted a retrospective analysis of all medication dosing alerts over a 1-year period (January 1 through December 31, 2008) for all pediatric inpatients at Hospital for Special Surgery. Alerts were analyzed with respect to medication dosing, prescriber, and action taken by the prescriber after the alert was triggered (i.e., accepted suggested change, ignored recommendation/overrode, or cancelled the order). Results: During the study period, 18,163 medication orders were placed and 1,024 dosing alerts were fired. Overdosing of medications accounted for 91% of the alerts and underdosing 9%. The pediatric-trained providers ignored more alerts and cancelled fewer orders than the non-pediatric-trained providers (p<0.001). Both groups changed the order similarly based on CDS recommendations. Conclusions: Differences in response to CDS were found between pediatric-trained and non-pediatric-trained providers caring for pediatric patients; however, both groups changed orders based on CDS similarly. CPOE with built-in CDS may be of particular value when providers with different specialties and types of training are caring for pediatric patients.

Computerized provider order entry system: Solution to improve patient safety

2013 ◽  
Vol 1 (3) ◽  
pp. 180
Author(s):  
Mahtab Kasaei ◽  
Fahimeh Sadeghi ◽  
Sakineh Saghaeiannejad ◽  
Vahideh Shirzad ◽  
Nahid Tavakoli ◽  
...  
Keyword(s):  
Patient Safety ◽  
Improve Patient Safety ◽  
Order Entry ◽  
Computerized Provider Order Entry ◽  
System Solution ◽  
Improve Patient

scholarly journals A Risk Analysis Method to Evaluate the Impact of a Computerized Provider Order Entry System on Patient Safety

2008 ◽  
Vol 15 (4) ◽  
pp. 453-460 ◽  
Author(s):  
P. Bonnabry ◽  
C. Despont-Gros ◽  
D. Grauser ◽  
P. Casez ◽  
M. Despond ◽  
...  
Keyword(s):  
Patient Safety ◽  
Risk Analysis ◽  
Analysis Method ◽  
Order Entry ◽  
Computerized Provider Order Entry ◽  
The Impact

Increased appropriateness of customized alert acknowledgement reasons for overridden medication alerts in a computerized provider order entry system

2015 ◽  
Vol 84 (12) ◽  
pp. 1085-1093 ◽  
Author(s):  
Brian M. Dekarske ◽  
Christopher R. Zimmerman ◽  
Robert Chang ◽  
Paul J. Grant ◽  
Bruce W. Chaffee
Keyword(s):  
Order Entry ◽  
Computerized Provider Order Entry
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