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Results for “Medical Order Entry Systems”

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At least 253 records · Page 14Linked to original sources
PubMed1995

A tool for provider interaction during patient care: G-CARE.

We have extended the CARE language to facilitate interaction with providers using the Medical Gopher order entry system during patient care to create G-CARE. We have used G-CARE in several randomized controlled trials and for routine clinical applications. The language has evolved and is now able to support nearly all of the decision support. Its flexibility allows G-CARE results to be used at many points throughout the patient care process. Based on actual use of G-CARE, we have found performance issues and lack of dynamically grouped order sets are limitations which need to be addressed.

Decision Making, Computer-Assisted↗
PubMed2006

Maintaining excellence in physician nurse communication with CPOE: A nursing informatics team approach.

Designing and implementing CPOE systems is difficult, presenting many challenges to overcome related to workflow redesign. As part of the Mayo Clinic Arizona CPOE design and implementation, it was recognized that physicians would be placing inpatient orders from multiple locations; therefore nurses no longer would have the usual visual clues to identify new physician orders. This could easily lead to a delay in implementing orders that require immediate action. To address this, a multidisciplinary team evaluated various communication options and designed two in-house Web-based applications to solve the communication gap. One application will provide staff nurses with visual alerts for stat and routine orders as they are processed in real time. A second application is a Web-based link to the nursing assignment sheets, which will give physicians and support staff access to staff nurse assignments and phone numbers, specific to each nursing unit.

Arizona↗
PubMed2006

Computerized provider order entry and patient safety.

Computerized provider order entry (CPOE) and clinical decision support (CDS) are advocated health care information technologies for improving patient safety through reduction and prevention of medication errors. CPOE and DCS target specific errors in medication processes, particularly in prescribing and ordering. These are of particular importance in pediatrics, because children may be more vulnerable to prescribing errors than adults. Studies of CPOE/CDS performed at academic medical centers have demonstrated their effectiveness in reducing medication process errors in pediatrics, but scant data so far show effects on health outcomes. CPOE/CDS adoption requires significant expertise in health care processes, information technology, and change management. Adoption is a high-cost, high-risk venture with political implications.

Child↗
PubMed2006

[Computerized physician order entry of pharmacotherapeutic protocols in a colorectal surgery unit].

INTRODUCTION: Computerized physician order entry was introduced in our hospital. We present the pharmacotherapeutic protocols that we use in patient care. MATERIAL AND METHODS: Six pharmaceutical protocols were designed by consensus in a colorectal surgery unit and were applied over a 2-year period. Patients undergoing ambulatory or urgent surgery were excluded. RESULTS: We treated 772 patients. Two hundred twenty patients (28.5%) were assigned to the preoperative protocol for minor proctologic surgery. After surgery, all 220 patients were included in the postoperative protocol for minor proctologic surgery. The remaining 552 patients (71.5%) were assigned to the protocol for major colorectal surgery. The preoperative protocol for major colorectal surgery was indicated in 542 patients (98.2%) and its variant for patients allergic to beta-lactam antibiotics was used in 10 patients (1.8%). The postoperative pharmacotherapeutic protocol assigned depended on whether a central venous line (317 patients; 57.4%) or only peripheral venous access (235 patients; 42.6%) was used. CONCLUSIONS: Each clinical unit has a duty to carry out and update consensus protocols (always based on the best scientific evidence available) that can be used in the processes managed in that unit. The use of these protocols shows a high degree of acceptance among physicians and nurses, allowing clinical practice to be standardized and healthcare processes to be homogenized.

Colorectal Surgery↗
PubMed2005

Organizational characteristics and the quality of surgical care.

PURPOSE OF REVIEW: Public recognition of wide variations in surgical outcomes has prompted numerous efforts aimed at measuring and improving quality. Given that many of the most prominent efforts focus on organizational factors, this paper reviews the growing body of evidence underlying these initiatives. RECENT FINDINGS: Physician, nurse, and pharmacist staffing are strongly related to outcomes for critically ill surgical patients. New technologic innovation, particularly computerized physician order entry, has the potential to markedly reduce medical errors in this population. Creating an infrastructure for the measurement and improvement of surgical quality also shows significant promise for improving outcomes. SUMMARY: Several organizational characteristics are strongly related outcomes for critically ill surgical patients. Increasing the number of surgical patients receiving care in hospitals adhering to these organizational practices would save many lives each year.

Critical Care↗
PubMed2006

A Jini-based solution for electronic prescriptions.

In most countries today, handwritten, paper-based medical prescriptions are the norm. While efforts have been made in the past and are being made at present to migrate toward electronic dispensation of prescriptions, these have generally omitted to incorporate ubiquitous computing technology in their proposed solutions. In this paper, we focus on this issue and describe a Jini-based prototypical solution for electronic prescriptions, which allows for their wireless transmission to in-range pharmacies and the augmentation of the service levels rendered to the user, with, for instance, information about queue lengths and estimated waiting times being provided to the patients. Clinical and user evaluation revealed that there were high levels of agreement as regards the prototype's effectiveness, ease of use, and usefulness.

Artificial Intelligence↗
PubMed2006

Transforming healthcare organizations.

Change in healthcare organizations is a complex task often fraught with unforeseen challenges. Based on the experiences of a multi-site hospital, and drawing on past research on organizational change, the author provides a model to help change leaders. Although relying on Toronto's University Health Network to illustrate the change model, the model is intended to speak to change leaders implementing various types of complex changes across a range of organizations.

Diffusion of Innovation↗
PubMed2006

Implementing MOE/MAR: balancing project management with change management.

When Toronto-based University Health Network initiated its Medication Order Entry/Medication Administration Record project in 2001, it was well understood by the organization that this would be one of the largest change management initiatives undertaken, and would require rigorous project management, significant clinical involvement and a well-developed change management program.

Diffusion of Innovation↗
PubMed2006

Thorough planning and full participation by pharmacists is key to MOE/MAR success.

The successful implementation of the Medication Order Entry/Medication Administration Record project was dependent on the Pharmacy department working collaboratively with many other stakeholders in the organization. To do this, the Pharmacy department faced numerous technical, staffing, workflow and clinical practice challenges during the design and implementation of MOE/ MAR.

Diffusion of Innovation↗
PubMed2006

Active physician participation key to smooth MOE/MAR rollout.

Fundamental to the project's success was acceptance of MOE/MAR by UHN's physicians, yet many physicians questioned whether MOE/MAR would impede their ability to care for their patients. To ensure physician adoption, UHN presented MOE/MAR as a patient safety initiative from the beginning.

Cooperative Behavior↗
PubMed2005

The introduction of computerized physician order entry and change management in a tertiary pediatric hospital.

OBJECTIVES: The objectives of this review were to document the introduction of computerized physician order entry (CPOE)-centered changes in an academic tertiary care center and to review the CPOE-focused literature. DESIGN: We performed a systematic literature review of CPOE-related articles indexed on Medline, with particular emphasis on pediatric applications. We focused our commentary around the concepts involved in the implementation process at a tertiary pediatric hospital. RESULTS: In 2001, the Children's Hospital of Pittsburgh (CHP) embarked on the process of CPOE design and implementation. We determined that CPOE is a tool for improving pediatric care. The CPOE implementation process is more than a technologic change; it involves an organizational cultural transformation. Although the complete transition to CPOE was little more than 1 year ago, CHP has overcome the typical obstacles of CPOE implementation to begin to realize its many benefits. The early success of CHP was achieved by creating a realistic, positive, work environment, which fostered hospital-wide participation and integration. CONCLUSION: CPOE is an invaluable resource for supporting patient safety in health care settings. The successful implementation of CPOE requires a paradigm shift in hospital policies and processes.

Efficiency, Organizational↗