J Am Med Inform Assoc - Temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system.

Tópicos

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Resumo

CKGROUND: A computerized physician order entry (CPOE) system with embedded clinical decision support can reduce medication errors in hospitals, but might increase the time taken to generate orders.AIMS: We aimed to quantify the effects of temporal (month, day of week, hour of shift) and other factors (grade of doctor, prior experience with the system, alert characteristics, and shift type) on the time taken to generate a prescription order.SETTING: A large university teaching hospital using a locally developed CPOE system with an extensive audit database.DESIGN: We retrospectively analyzed prescription orders from the audit database between August 2011 and July 2012.RESULTS: The geometric mean time taken to generate a prescription order within the CPOE system was 11.75 s (95% CI 11.72 to 11.78). Time to prescribe was most affected by the display of high-level (24.59 s (24.43 to 24.76); p<0.001) or previously unseen (18.87 s (18.78 to 18.96); p<0.001) alerts. Prescribers took significantly less time at weekends (11.29 s (11.23 to 11.35)) than on weekdays (11.88 s (11.84 to 11.91); p<0.001), in the first (11.25 s (11.16 to 11.34); p<0.001) and final (11.56 s (11.47 to 11.66); p<0.001) hour of their shifts, and after the first month of using the system.CONCLUSIONS: The display of alerts, prescribing experience, system familiarity, and environment all affect the time taken to generate a prescription order. Our study reinforces the need for appropriate alerts to be presented to individuals at an appropriate place in the workflow, in order to improve prescribing efficiency.

Resumo Limpo

ckground computer physician order entri cpoe system embed clinic decis support can reduc medic error hospit might increas time taken generat ordersaim aim quantifi effect tempor month day week hour shift factor grade doctor prior experi system alert characterist shift type time taken generat prescript orderset larg univers teach hospit use local develop cpoe system extens audit databasedesign retrospect analyz prescript order audit databas august juli result geometr mean time taken generat prescript order within cpoe system s ci time prescrib affect display highlevel s p previous unseen s p alert prescrib took signific less time weekend s weekday s p first s p final s p hour shift first month use systemconclus display alert prescrib experi system familiar environ affect time taken generat prescript order studi reinforc need appropri alert present individu appropri place workflow order improv prescrib effici

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