74: Comparison of Lab and X-ray Turnaround Times Before and After Implementation of Computerized Physician Order Entry in an Emergency Department

17058 Background: Computerized physician order entry (CPOE) in electronic medical records (EMR) has been recognized as an important tool in optimal health care provision that can reduce errors and improve safety. The objective of this study is to describe documentation completeness and user satisfaction of medical charts before and after outpatient oncology EMR/CPOE system implementation in a hospital based outpatient cancer center within three treatment sites and with sixteen physicians. Methods: A retrospective chart review was conducted on 32 randomly selected patients to date, who received one of the following regimens: FOLFOX, carboplatin-paclitaxel, CHOP-rituximab, or AC between 1999 and 2006. Charts were case matched with physician and regimen to compare documentation completeness. Completeness scores were assigned to each chart based on the number of documented data points found out of the 33 data points assessed. A user satisfaction survey of the paper chart and EMR/CPOE system was conducted among the physicians (n=16), nurses (n=43), and pharmacists (n=8) who worked with both systems. Results: The mean percentage of identified data points successfully found in the EMR/CPOE charts was 94% vs. 68% in the paper charts (p<0.001). Regimen complexity did not alter the number of data points found. The survey response rate was 64% and the results showed that satisfaction was statistically significant in favor of the EMR/CPOE system. The time required to find the data points will be assessed by having a physician, nurse, and pharmacist review the same charts. Data on 112 charts will be presented. Conclusions: Using EMR/CPOE systems improves completeness of medical record and chemotherapy order documentation and improves user satisfaction with the medical record system. No significant financial relationships to disclose.

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Time Motion Study in a Pediatric Emergency Department Before and After Computer Physician Order Entry

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2008.09.018 ◽

2009 ◽

Vol 53 (4) ◽

pp. 462-468.e1 ◽

Cited By ~ 42

Author(s):

Kenneth Yen ◽

Elizabeth L. Shane ◽

Sachin S. Pawar ◽

Nicole D. Schwendel ◽

Robert J. Zimmanck ◽

...

Keyword(s):

Emergency Department ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Order Entry ◽

Time Motion ◽

Motion Study ◽

Before And After ◽

Physician Order Entry

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Evaluation of Opioid Reversal with Naloxone before and after Implementation of a Computerized Physician Order Entry System at a Tertiary Medical Center

Journal of Pharmacy and Pharmacology ◽

10.17265/2328-2150/2018.03.001 ◽

2018 ◽

Vol 6 (3) ◽

Author(s):

Shannon Inglet ◽

Michael Curcio ◽

Lada Radetic

Keyword(s):

Medical Center ◽

Computerized Physician Order Entry ◽

Order Entry ◽

Before And After ◽

Physician Order Entry

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Medication Administration Variances Before and After Implementation of Computerized Physician Order Entry in a Neonatal Intensive Care Unit

PEDIATRICS ◽

10.1542/peds.2007-0919 ◽

2008 ◽

Vol 121 (1) ◽

pp. 123-128 ◽

Cited By ~ 40

Author(s):

J. A. Taylor ◽

L. A. Loan ◽

J. Kamara ◽

S. Blackburn ◽

D. Whitney

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Medication Administration ◽

Computerized Physician Order Entry ◽

Order Entry ◽

Before And After ◽

Physician Order Entry

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Improving adherence to the Epic Beacon ambulatory workflow

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155216637215 ◽

2016 ◽

Vol 23 (4) ◽

pp. 273-277 ◽

Cited By ~ 1

Author(s):

Ellen Chackunkal ◽

Vishnuprabha Dhanapal Vogel ◽

Meredith Grycki ◽

Diana Kostoff

Keyword(s):

Compliance Rate ◽

Medication Administration ◽

Computerized Physician Order Entry ◽

Order Entry ◽

Center Staff ◽

Ambulatory Oncology ◽

Before And After ◽

Henry Ford ◽

Quasi Experimental ◽

Physician Order Entry

Computerized physician order entry has been shown to significantly improve chemotherapy safety by reducing the number of prescribing errors. Epic's Beacon Oncology Information System of computerized physician order entry and electronic medication administration was implemented in Henry Ford Health System's ambulatory oncology infusion centers on 9 November 2013. Since that time, compliance to the infusion workflow had not been assessed. The objective of this study was to optimize the current workflow and improve the compliance to this workflow in the ambulatory oncology setting. This study was a retrospective, quasi-experimental study which analyzed the composite workflow compliance rate of patient encounters from 9 to 23 November 2014. Based on this analysis, an intervention was identified and implemented in February 2015 to improve workflow compliance. The primary endpoint was to compare the composite compliance rate to the Beacon workflow before and after a pharmacy-initiated intervention. The intervention, which was education of infusion center staff, was initiated by ambulatory-based, oncology pharmacists and implemented by a multi-disciplinary team of pharmacists and nurses. The composite compliance rate was then reassessed for patient encounters from 2 to 13 March 2015 in order to analyze the effects of the determined intervention on compliance. The initial analysis in November 2014 revealed a composite compliance rate of 38%, and data analysis after the intervention revealed a statistically significant increase in the composite compliance rate to 83% ( p < 0.001). This study supports a pharmacist-initiated educational intervention can improve compliance to an ambulatory, oncology infusion workflow.

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Impact of Computerized Order Entry to Pharmacy Interface on Order-Infusion Pump Discrepancies

Journal of Drug Delivery ◽

10.1155/2015/686598 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Rebecca A. Russell ◽

David Triscari ◽

Kathy Murkowski ◽

Matthew C. Scanlon

Keyword(s):

Intensive Care Unit ◽

Infusion Pump ◽

Healthcare Delivery ◽

Pediatric Intensive Care ◽

Computerized Physician Order Entry ◽

Order Entry ◽

Computerized Order Entry ◽

Before And After ◽

Discrepancy Rate ◽

Physician Order Entry

Background. The ability of safety technologies to decrease errors, harm, and risk to patients has yet to be demonstrated consistently. Objective. To compare discrepancies between medication and intravenous fluid (IVF) orders and bedside infusion pump settings within a pediatric intensive care unit (PICU) before and after implementation of an interface between computerized physician order entry (CPOE) and pharmacy systems. Methods. Within a 72-bed PICU, medication and IVF orders in the CPOE system and bedside infusion pump settings were collected. Rates of discrepancy were calculated and categorized by type. Results were compared to a study conducted prior to interface implementation. Expansion of PICU also occurred between study periods. Results. Of 455 observations, discrepancy rate decreased for IVF (p=0.01) compared to previous study. Overall discrepancy rate for medications was unchanged; however, medications infusing without an order decreased (p<0.01), and orders without corresponding infusion increased (p<0.05). Conclusions. Following implementation of an interface between CPOE and pharmacy systems, fewer discrepancies between IVF orders and infusion pump settings were observed. Discrepancies for medications did not change, and some types of discrepancies increased. In addition to interface implementation, changes in healthcare delivery and workflow related to ICU expansion contributed to observed changes.

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