Arpi Bekmezian1, Paul J Chung, Shahram Yazdani. 1. Division of General Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California 94143-0110, USA. bekmeziana@peds.ucsf.edu
Abstract
BACKGROUND: Few studies exist on the ability of standardized preprinted order forms to improve patient care. OBJECTIVE: To examine resident-perceived effects of introducing a pediatric admission order set (PAOS) on the quality of inpatient care. DESIGN: Cross-sectional study. SETTING: University of California, Los Angeles (UCLA) Children's Hospital, a nonprofit, tertiary-care teaching hospital and major referral center with approximately 3,000 admissions per year. PARTICIPANTS: A total of 97 pediatric residents (PL-1, n=34; PL-2, n=33; and PL-3, n=30) who did the vast majority of the inpatient admissions. MEASUREMENTS: Residents were asked to rate the PAOS overall and with respect to 9 specific dimensions using a 5-point Likert scale. RESULTS: Overall, 89% of respondents approved of the PAOS, 58% reported using it >or= 90% of the time, and all said that they would recommend it to their colleagues. Eighty-four percent thought that it improved inpatient care, and 75% thought that medical errors were reduced. Eighty-eight percent reported that the PAOS saved time; 93% said it was convenient; and most reported less need for clarification with secretaries (81%) and nurses (82%). In multivariate regression analyses, the only predictor of overall rating was whether the PAOS improved inpatient care (P=0.04). Improved patient care, meanwhile, was predicted by whether the PAOS was comprehensive (P=0.01), reduced medical errors (P=0.01), and required less clarification with nurses (P=0.01). CONCLUSIONS: A standardized admission order set is a simple, low-cost intervention that residents believe may benefit patients by reducing medical errors and expediting high-quality care.
BACKGROUND: Few studies exist on the ability of standardized preprinted order forms to improve patient care. OBJECTIVE: To examine resident-perceived effects of introducing a pediatric admission order set (PAOS) on the quality of inpatient care. DESIGN: Cross-sectional study. SETTING: University of California, Los Angeles (UCLA) Children's Hospital, a nonprofit, tertiary-care teaching hospital and major referral center with approximately 3,000 admissions per year. PARTICIPANTS: A total of 97 pediatric residents (PL-1, n=34; PL-2, n=33; and PL-3, n=30) who did the vast majority of the inpatient admissions. MEASUREMENTS: Residents were asked to rate the PAOS overall and with respect to 9 specific dimensions using a 5-point Likert scale. RESULTS: Overall, 89% of respondents approved of the PAOS, 58% reported using it >or= 90% of the time, and all said that they would recommend it to their colleagues. Eighty-four percent thought that it improved inpatient care, and 75% thought that medical errors were reduced. Eighty-eight percent reported that the PAOS saved time; 93% said it was convenient; and most reported less need for clarification with secretaries (81%) and nurses (82%). In multivariate regression analyses, the only predictor of overall rating was whether the PAOS improved inpatient care (P=0.04). Improved patient care, meanwhile, was predicted by whether the PAOS was comprehensive (P=0.01), reduced medical errors (P=0.01), and required less clarification with nurses (P=0.01). CONCLUSIONS: A standardized admission order set is a simple, low-cost intervention that residents believe may benefit patients by reducing medical errors and expediting high-quality care.