J Am Med Inform Assoc - Improving the utilization of admission order sets in a computerized physician order entry system by integrating modular disease specific order subsets into a general medicine admission order set.

Tópicos

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Resumo

SE DESCRIPTION: We evaluated the effects of integrating order subsets for the most common medical diagnoses into a general medical admission order set of our electronic medical records (EMR) in order to improve order set integration by clinicians.METHODS OF IMPLEMENTATION: We identified the most common primary and secondary diagnoses for patients admitted to our medical service and developed order subsets comprising only of the orders necessary for the management of these individual diagnoses. Using the capabilities of our computerized physician order entry (CPOE), we nested these order subsets into the general order set and evaluated the resulting change in order set utilization by our clinicians.EXAMPLE AND OBSERVATIONS: The total number of order sets used by clinicians in all departments increased fivefold during the 16-month period following the implementation of the integrated order sets in July 2008. A before and after time series was used to analyze the trend in increased order set usage and showed an effect of the intervention (p=0.023).DISCUSSION: Integration of disease specific order subsets into a single general admission order set significantly improved the overall adoption of order sets by clinicians. This provides health care systems with the opportunity to improve patient safety and implement evidence based care in clinical practice.

Resumo Limpo

se descript evalu effect integr order subset common medic diagnos general medic admiss order set electron medic record emr order improv order set integr cliniciansmethod implement identifi common primari secondari diagnos patient admit medic servic develop order subset compris order necessari manag individu diagnos use capabl computer physician order entri cpoe nest order subset general order set evalu result chang order set util cliniciansexampl observ total number order set use clinician depart increas fivefold month period follow implement integr order set juli time seri use analyz trend increas order set usag show effect intervent pdiscuss integr diseas specif order subset singl general admiss order set signific improv overal adopt order set clinician provid health care system opportun improv patient safeti implement evid base care clinic practic

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