BACKGROUND: The use of computerized provider order entry (CPOE) has been widely linked to improvements in patient safety. We hypothesized that electronic routing of CPOE-generated orders through individual pagers would improve the efficiency of STAT radiographic studies and respiratory treatments. METHODS: The study was conducted in two periods before and after implementing pager notification of STAT orders. In the Baseline Period, CPOE-generated STAT orders were communicated to radiology technicians or respiratory therapists through the use of printed orders, manual paging and/or telephone communication. The time to process the order and deliver a radiology result or respiratory treatment was tracked. In the Intervention Period CPOE-generated STAT orders were electronically routed to the radiology technician's or respiratory therapist's pager. During both time periods, clinicians completed user satisfaction surveys. RESULTS: Using pager notification, there was a significant reduction in radiology technician arrival time (16.8±2.1 vs 7.9±0.7 mins, p<0.001). Similarly there was a significant reduction in the cumulative time required to capture the radiographic image, image availability in the picture archiving and communication system (PACS) and the verbal report from the radiologist (p<0.05). The time required in obtaining a preliminary or final radiographic written report and the total cycle times were not significantly reduced. For STAT respiratory therapy orders there was a significant reduction in the mean time from ordering to administration of respiratory therapy treatments (124.7±14.1 vs 49.8±11.4 minutes, p<0.01). Radiologists, respiratory therapists and ordering clinicians reported improved satisfaction after implementation of pager notification. CONCLUSION: Computer-generated orders for STAT radiographic studies and respiratory treatments can be carried out significantly faster through the use of direct pager notification. The implementation of this process has resulted in improved care delivery and widespread clinician satisfaction.
BACKGROUND: The use of computerized provider order entry (CPOE) has been widely linked to improvements in patient safety. We hypothesized that electronic routing of CPOE-generated orders through individual pagers would improve the efficiency of STAT radiographic studies and respiratory treatments. METHODS: The study was conducted in two periods before and after implementing pager notification of STAT orders. In the Baseline Period, CPOE-generated STAT orders were communicated to radiology technicians or respiratory therapists through the use of printed orders, manual paging and/or telephone communication. The time to process the order and deliver a radiology result or respiratory treatment was tracked. In the Intervention Period CPOE-generated STAT orders were electronically routed to the radiology technician's or respiratory therapist's pager. During both time periods, clinicians completed user satisfaction surveys. RESULTS: Using pager notification, there was a significant reduction in radiology technician arrival time (16.8±2.1 vs 7.9±0.7 mins, p<0.001). Similarly there was a significant reduction in the cumulative time required to capture the radiographic image, image availability in the picture archiving and communication system (PACS) and the verbal report from the radiologist (p<0.05). The time required in obtaining a preliminary or final radiographic written report and the total cycle times were not significantly reduced. For STAT respiratory therapy orders there was a significant reduction in the mean time from ordering to administration of respiratory therapy treatments (124.7±14.1 vs 49.8±11.4 minutes, p<0.01). Radiologists, respiratory therapists and ordering clinicians reported improved satisfaction after implementation of pager notification. CONCLUSION: Computer-generated orders for STAT radiographic studies and respiratory treatments can be carried out significantly faster through the use of direct pager notification. The implementation of this process has resulted in improved care delivery and widespread clinician satisfaction.
Entities:
Keywords:
Care orders; Computerized provider order entry; Efficiency; Radiology; Respiratory therapy
Authors: Sunita Saxena; Raymond Kempf; Susan Wilcox; Ira A Shulman; Louise Wong; Glenn Cunningham; Elaine Vega; Stephanie Hall Journal: Jt Comm J Qual Patient Saf Date: 2005-09
Authors: Wayne A Wilbright; Robert Marier; Amir Abrams; Luis Smith; Duc Tran; Alan Thriffiley; Michael K Butler; Elmore Rigamer; Clayton Williams; Robert Post Journal: AMIA Annu Symp Proc Date: 2005
Authors: G J Kuperman; J M Teich; M J Tanasijevic; N Ma'Luf; E Rittenberg; A Jha; J Fiskio; J Winkelman; D W Bates Journal: J Am Med Inform Assoc Date: 1999 Nov-Dec Impact factor: 4.497
Authors: D W Bates; J M Teich; J Lee; D Seger; G J Kuperman; N Ma'Luf; D Boyle; L Leape Journal: J Am Med Inform Assoc Date: 1999 Jul-Aug Impact factor: 4.497
Authors: Adam Wright; Dean F Sittig; Joan S Ash; Joshua Feblowitz; Seth Meltzer; Carmit McMullen; Ken Guappone; Jim Carpenter; Joshua Richardson; Linas Simonaitis; R Scott Evans; W Paul Nichol; Blackford Middleton Journal: J Am Med Inform Assoc Date: 2011-03-17 Impact factor: 4.497