FUJI-Scheduler : Outpatient-Test-Order-Management Function for Order Entry System

2006 ◽  
Author(s):  
Shuichi Toyoda ◽  
Noboru Niki ◽  
Hiromu Nishitani
Keyword(s):  
Order Entry ◽  
Order Management ◽  
Management Function ◽  
Test Order

Accuracy of Send-Out Test Ordering: A College of American Pathologists Q-Probes Study of Ordering Accuracy in 97 Clinical Laboratories

2008 ◽  
Vol 132 (2) ◽  
pp. 206-210
Author(s):  
Paul N. Valenstein ◽  
Molly K. Walsh ◽  
Ana K. Stankovic
Keyword(s):  
Laboratory Tests ◽  
Error Rates ◽  
Reference Laboratory ◽  
Patient Evaluation ◽  
Order Entry ◽  
Order Accuracy ◽  
Specific Test ◽  
Clinical Laboratories ◽  
Test Order ◽  
Test Ordering

Abstract Context.—Errors entering orders for send-out laboratory tests into computer systems waste health care resources and can delay patient evaluation and management. Objectives.—To determine (1) the accuracy of send-out test order entry under “real world” conditions and (2) whether any of several practices are associated with improved order accuracy. Design.—Representatives from 97 clinical laboratories provided information about the processes they use to send tests to reference facilities and their order entry and specimen routing error rates. Results.—In aggregate, 98% of send-out tests were correctly ordered and 99.4% of send-out tests were routed to the proper reference laboratory. There was wide variation among laboratories in the rate of send-out test order entry errors. In the bottom fourth of laboratories, more than 5% of send-out tests were ordered incorrectly, while in the top fourth of laboratories fewer than 0.3% of tests were ordered incorrectly. Order entry errors were less frequent when a miscellaneous test code was used than when a specific test code was used (3.9% vs 5.6%; P = .003). Conclusions.—Computer order entry errors for send-out tests occur approximately twice as frequently as order entry errors for other types of tests. Filing more specific test codes in a referring institution's information system is unlikely to reduce order entry errors and may make error rates worse.

scholarly journals Orders on file but no labs drawn: investigation of machine and human errors caused by an interface idiosyncrasy

2017 ◽  
Vol 24 (5) ◽  
pp. 958-963 ◽  
Author(s):  
Richard Schreiber ◽  
Dean F Sittig ◽  
Joan Ash ◽  
Adam Wright
Keyword(s):  
Laboratory Tests ◽  
Clinical Laboratory ◽  
Unintended Consequences ◽  
New Order ◽  
Laboratory System ◽  
Order Entry ◽  
Timely Manner ◽  
Human Errors ◽  
Order Management ◽  
User Actions

Abstract In this report, we describe 2 instances in which expert use of an electronic health record (EHR) system interfaced to an external clinical laboratory information system led to unintended consequences wherein 2 patients failed to have laboratory tests drawn in a timely manner. In both events, user actions combined with the lack of an acknowledgment message describing the order cancellation from the external clinical system were the root causes. In 1 case, rapid, near-simultaneous order entry was the culprit; in the second, astute order management by a clinician, unaware of the lack of proper 2-way interface messaging from the external clinical system, led to the confusion. Although testing had shown that the laboratory system would cancel duplicate laboratory orders, it was thought that duplicate alerting in the new order entry system would prevent such events.

scholarly journals Improving laboratory test utilisation at the multihospital Yale New Haven Health System

2019 ◽  
Vol 8 (3) ◽  
pp. e000689 ◽  
Author(s):  
Roa Harb ◽  
David Hajdasz ◽  
Marie L Landry ◽  
L Scott Sussman
Keyword(s):  
Laboratory Test ◽  
Cost Savings ◽  
Physician Education ◽  
Daily Routine ◽  
New Haven ◽  
Order Entry ◽  
Utilisation Management ◽  
Test Order ◽  
Physician Order Entry ◽  
The Impact

BackgroundWaste persists in healthcare and negatively impacts patients. Clinicians have direct control over test ordering and ongoing international efforts to improve test utilisation have identified multifaceted approaches as critical to the success of interventions. Prior to 2015, Yale New Haven Health lacked a coherent strategy for laboratory test utilisation management.MethodsIn 2015, a system-wide laboratory formulary committee was formed at Yale New Haven Health to manage multiple interventions designed to improve test utilisation. We report here on specific interventions conducted between 2015 and 2017 including reduction of (1) obsolete or misused testing, (2) duplicate orders, and (3) daily routine lab testing. These interventions were driven by a combination of modifications to computerised physician order entry, test utilisation dashboards and physician education. Measurements included test order volume, blood savings and cost savings.ResultsTesting for a number of obsolete/misused analytes was eliminated or significantly decreased depending on alert rule at order entry. Hard stops significantly decreased duplicate testing and educational sessions significantly decreased daily orders of routine labs and increased blood savings but the impact waned over time for select groups. In total, we realised approximately $100 000 of cost savings during the study period.ConclusionThrough a multifaceted approach to utilisation management, we show significant reductions in low-value clinical testing that have led to modest but significant savings in both costs and patients’ blood.

Outpatient Order Accuracy

1999 ◽  
Vol 123 (12) ◽  
pp. 1145-1150 ◽  
Author(s):  
Paul Valenstein ◽  
Frederick Meier
Keyword(s):  
Error Rate ◽  
Error Rates ◽  
Order Entry ◽  
Cross Sectional Survey ◽  
Order Accuracy ◽  
Cross Sectional ◽  
Laboratory Staff ◽  
Test Order ◽  
Specific Error ◽  
System Order

Abstract Context.—Laboratory test order entry errors potentially delay diagnosis, consume resources, and cause patient inconvenience. Objective.—To evaluate the frequency and causes of computer order entry errors in outpatients. Design.—Cross-sectional survey and prospective sample of errors. Participants answered questions about their test order entry policies and practices. They then examined a sample of outpatient requisitions and compared information on the requisition with information entered into the laboratory computer system. Order entry errors were divided into 4 types: tests ordered on the requisition, but not in the computer; tests performed but not ordered on the requisition; physician name discrepancies; and test priority errors. Participants.—Six hundred sixty laboratories enrolled in the College of American Pathologists Q-Probes program. Main Outcome Measure.—Overall order entry error rate. Results.—A total of 5514 (4.8%) of 114 934 outpatient requisitions were associated with at least 1 order entry error. The median participant reported 1 or more order errors on 6.0% of requisitions; 10% of institutions reported errors with at least 18% of requisitions. Of the 4 specific error types, physician name discrepancies had the highest error rate, and test priority errors the lowest error rate. Four institutional factors were significantly associated with higher overall error rates: orders verbally communicated to the laboratory; no policy requiring laboratory staff to compare a printout or display of ordered tests with the laboratory requisitions to confirm that orders had been entered correctly; failure to monitor the accuracy of outpatient order entry on a regular basis; and a higher percentage of occupied beds (ie, a busier hospital). Conclusions.—Computer order entry errors are common, involving 5% of outpatient requisitions. Laboratories may be able to decrease error rates by regularly monitoring the accuracy of order entry, substituting written and facsimile orders for verbal orders, and instituting a policy in which orders entered into computer systems are routinely rechecked against orders on requisitions.

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