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

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.

DD-012 A risk analysis method to evaluate the impact of robotic dispensing on patient safety

2016 ◽  
Vol 23 (Suppl 1) ◽  
pp. A109.2-A110
Author(s):  
CG Rodriguez-Gonzalez ◽  
A Herranz-Alonso ◽  
V Escudero-Vilaplana ◽  
MA Ais-Larisgoitia ◽  
A Ribed-Sanchez ◽  
...  
Keyword(s):  
Patient Safety ◽  
Risk Analysis ◽  
Analysis Method ◽  
The Impact

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 CPOE in Non-Surgical Versus Surgical Specialties: A Qualitative Comparison of Clinical Contexts in the Medication Process

2010 ◽  
Vol 4 (1) ◽  
pp. 206-213 ◽  
Author(s):  
Zahra Niazkhani ◽  
Habibollah Pirnejad ◽  
Antoinette de Bont ◽  
Jos Aarts
Keyword(s):  
Information Needs ◽  
Order Entry ◽  
Clinical Context ◽  
Qualitative Comparison ◽  
Computerized Provider Order Entry ◽  
Medication Process ◽  
Positive Attitudes ◽  
Perceived Impact ◽  
The Impact

Background: Computerized provider order entry (CPOE) systems are implemented in various clinical contexts of a hospital. To identify the role of the clinical context in CPOE use, we compared the impact of a CPOE system on the medication process in both non-surgical and surgical specialties. Methods: We conducted a qualitative study of surgical and non-surgical specialties in a 1237-bed, academic hospital in the Netherlands. We interviewed the clinical end users of a computerized medication order entry system in both specialty types and analyzed the interview transcripts to elicit qualitative differences between the clinical contexts, clinicians’ attitudes, and specialty-specific requirements. Results: Our study showed that the differences in clinical contexts between non-surgical and surgical specialties resulted in a disparity between clinicians’ requirements when using CPOE. Non-surgical specialties had a greater medication workload, greater and more diverse information needs to be supported in a timely manner by the system, and thus more intensive interaction with the CPOE system. In turn these factors collectively influenced the perceived impact of the CPOE system on the clinicians’ practice. The non-surgical clinicians expressed less positive attitudes compared to the surgical clinicians, who perceived their interaction with the system to be less intensive and less problematic. Conclusion: Our study shows that clinicians’ different attitudes towards the system and the perceived impact of the system were largely grounded in the clinical context of the units. The study suggests that not merely the CPOE system, the technology itself, influences the perceptions of its users and workflow-related outcomes. The interplay between technology and clinical context of the implementation environment also matters. System design and redesigning efforts should take account of different units’ specific requirements in their particular clinical contexts.

scholarly journals The impact of computerized provider order entry on medication errors in a multispecialty group practice

2010 ◽  
Vol 17 (1) ◽  
pp. 78-84 ◽  
Author(s):  
Emily Beth Devine ◽  
Ryan N Hansen ◽  
Jennifer L Wilson-Norton ◽  
N M Lawless ◽  
Albert W Fisk ◽  
...  
Keyword(s):  
Medication Errors ◽  
Group Practice ◽  
Order Entry ◽  
Computerized Provider Order Entry ◽  
Multispecialty Group ◽  
The Impact

scholarly journals Impact of commercial computerized provider order entry (CPOE) and clinical decision support systems (CDSSs) on medication errors, length of stay, and mortality in intensive care units: a systematic review and meta-analysis

2016 ◽  
Vol 24 (2) ◽  
pp. 413-422 ◽  
Author(s):  
Mirela Prgomet ◽  
Ling Li ◽  
Zahra Niazkhani ◽  
Andrew Georgiou ◽  
Johanna I Westbrook
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Medication Errors ◽  
Meta Analysis ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Order Entry ◽  
Icu Mortality ◽  
Computerized Provider Order Entry ◽  
The Impact

Objective: To conduct a systematic review and meta-analysis of the impact of commercial computerized provider order entry (CPOE) and clinical decision support systems (CDSSs) on medication errors, length of stay (LOS), and mortality in intensive care units (ICUs). Methods: We searched for English-language literature published between January 2000 and January 2016 using Medline, Embase, and CINAHL. Titles and abstracts of 586 unique citations were screened. Studies were included if they: (1) reported results for an ICU population; (2) evaluated the impact of CPOE or the addition of CDSSs to an existing CPOE system; (3) reported quantitative data on medication errors, ICU LOS, hospital LOS, ICU mortality, and/or hospital mortality; and (4) used a randomized controlled trial or quasi-experimental study design. Results: Twenty studies met our inclusion criteria. The transition from paper-based ordering to commercial CPOE systems in ICUs was associated with an 85% reduction in medication prescribing error rates and a 12% reduction in ICU mortality rates. Overall meta-analyses of LOS and hospital mortality did not demonstrate a significant change. Discussion and Conclusion: Critical care settings, both adult and pediatric, involve unique complexities, making them vulnerable to medication errors and adverse patient outcomes. The currently limited evidence base requires research that has sufficient statistical power to identify the true effect of CPOE implementation. There is also a critical need to understand the nature of errors arising post-CPOE and how the addition of CDSSs can be used to provide greater benefit to delivering safe and effective patient care.

scholarly journals Healthcare Quality Improvement Analytics: An Example Using Computerized Provider Order Entry

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1187
Author(s):  
Jungwon Cho ◽  
Sangmi Shin ◽  
Youngmi Jeong ◽  
Eunsook Lee ◽  
Soyeon Ahn ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Control Chart ◽  
Healthcare Professionals ◽  
Segmented Regression ◽  
Long Term Effects ◽  
Order Entry ◽  
Post Intervention ◽  
Computerized Provider Order Entry ◽  
Healthcare Settings ◽  
The Impact

Evaluation of sustainability after quality improvement (QI) projects in healthcare settings is an essential part of monitoring and future QI planning. With limitations in adopting quasi-experimental study design in real-world practice, healthcare professionals find it challenging to present the sustained effect of QI changes effectively. To provide quantitative methodological approaches for demonstrating the sustainability of QI projects for healthcare professionals, we conducted data analyses based on a QI project to improve the computerized provider order entry system to reduce patients’ dosing frequencies in Korea. Data were collected for 5 years: 24-month pre-intervention, 12-month intervention, and 24-month post-intervention. Then, analytic approaches including control chart, Analysis of Variance (ANOVA), and segmented regression were performed. The control chart intuitively displayed how the outcomes changed over the entire period, and ANOVA was used to test whether the outcomes differed between groups. Last, segmented regression analysis was conducted to evaluate longitudinal effects of interventions over time. We found that the impact of QI projects in healthcare settings should be initiated following the Plan–Do–Study–Act cycle and evaluated long-term effects while widening the scope of QI evaluation with sustainability. This study can serve as a guide for healthcare professionals to use a number of statistical methodologies in their QI evaluations.

Impact of Computerized Prescriber Order Entry (CPOE) on Clinical Pharmacy Practice: A Hypothesis-Generating Study

2007 ◽  
Vol 42 (10) ◽  
pp. 931-938 ◽  
Author(s):  
Josephine S. Lai ◽  
Glenn Yokoyama ◽  
Clifton Louie ◽  
Jim Lightwood
Keyword(s):  
Patient Safety ◽  
Pharmacy Practice ◽  
Order Entry ◽  
Advantages And Disadvantages ◽  
Medical Centers ◽  
Academic Medical ◽  
Staffing Requirements ◽  
The Impact ◽  
Pharmacy Leaders ◽  
Computerized Prescriber Order Entry

Since the Institute of Medicine's 1999 landmark report on patient safety, much literature have been published to show the advantages and disadvantages of information systems such as computerized prescriber order entry (CPOE) on improving the delivery of health care. The primary end points of this study were to assess the potential impact of CPOE on patient safety, as well as pharmacy practice and profession—based on the experience and/or opinions of selected pharmacy leaders in California. A qualitative method using multidimensional scaling (MDS), a hypothesis generating tool, was used for data analysis. Most pharmacy leaders held positive opinions regarding the impact of CPOE on the pharmacy practice and the profession, with varying concerns regarding its impact on practice and safety. The MDS analysis showed that leaders from community hospitals held the most optimistic beliefs on CPOE's impact compared with leaders from the academic medical centers and government hospitals whom held concerns over the effect on pharmacy workflow, staffing requirements, and safety. Further studies with more observations should be conducted to assess the impact of CPOE on the pharmacy department.

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