Improving the delivery of healthcare by using a CPOE system
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You are the informatics nurse for a 250-bed acute care facility planning to "go live" with EHR in 12 months. You have been tasked with preparing the physicians who admit patients to your facility for the conversion to computer physician order entry (CPOE).
a) Describe how you will go about achieving "buy in" from physicians who might resist the process
b) How will you undertake the training of physicians to use CPOE?
c) Upon "go live" there have been some instances at other facilities where the physicians increase utilization of verbal orders as a means to "work around" the CPOE system. Anticipating this possibility, how will you address and prevent it?
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Solution Summary
When properly implemented, a computerized physician order entry (CPOE) system can improve the morbidity and mortality or patients while simultaneously lower hospitilization stays and healthcare costs. In order to be effective, there must be buy-in from all stakeholders, and a formalized training regimen with associated continual re-evaluation fo efficacy.
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Process improvement is a fundamental aspect of an organizational structure and implementing a computerized physician order entry (CPOE) system is no exception. It is also a noble endeavor as adverse drug events (ADE) are representative of the largest single category of adverse events experienced by hospitalized patients, accounting for approximately 19 percent of all injuries (1). Given that context, getting "buy-in" from physicians may not be cumbersome from that vantage point of increase medicolegal liability. In that same vein, patient morbidity and mortality will be decreased utilizing the CPOE. From a business perspective, a 2007 report from the Institute of Medicine estimated between 380,000 and 450,000 preventable ADEs occurred annually in United States hospitals (2). Categorically, these medical errors cost an estimated 3.5 billion dollars in 2006. From every aspect, it is in the interest of all stakeholders, namely physicians, to take an interest in ways to minimize ADEs and improve the delivery of healthcare.
Improved accuracy of data decreases ADEs, but when coupled with a clinical decision support system (CDSS), physicians can maximize their efforts when delivering care. CDSS includes interactive designed to assist healthcare professionals in making clinical choices which would invariably improve the support and usage of CPOEs by ...
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