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Elements of Systems Assessments, Term Paper Example

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Term Paper

According to Koppel et al (2005), the estimated number of adverse drug events injure and/or bring death to over 770,000 patients each year. The most frequent reason for these errors is in the prescription process. This is a process that has the ability to be examined and altered so the number of medication prescribing errors are significantly decreased. One such way to do this is by the use of a computerized physician order entry system (Koppel, et al., 2005). These systems have gained popularity as the nation moves towards an electronic implementation of medical information in general and there are researchers, clinicians, administrators, pharmacists, and numerous other professionals who advocate the use of such a system for an increased safety mechanism (Koppel, et al., 2005; Stone, Smith, Shaft, Nelson, & Money, 2009). This article explains the CPOE, assesses the system, and goes further in depth with an implementation strategy if such a system was elected as a choice in the hospital.

Description of CPOE System

The computerized physician order entry system is a system that allows for the direct entry of physician’s orders into a computer by either the attending physician or another authorized user such as a nurse practitioner, nurse, or medical student (Doolan & Bates, 2002). There are advantages to this system, such as a decrease in the amount of written and verbal transcription required regarding the health status of each patient, the increase in accuracy of the information that is added to the system because of the elimination of the ‘shorthand’ method of physician dictation, and the ability to enter patient orders in a variety of locations even when the patient is not physically on the same floor as physician during the moment the order requires modification (Doolan & Bates, 2002).

Therefore, the CPOE system is not necessarily one kind of specific system; rather, it is a classification of various electronic systems that are capable of being utilized for the specific purpose of inputting patient’s orders and information into a database by a physician or designee in lieu of a paper chart. It serves as a way for physicians to have better access to patients because the system may be configured to allow for physicians to carry electronic devices to and from patient rooms in order to make notes for inputting into the system database. The advantages of such a system can be quite beneficial to a hospital administration in regards to decreased medical errors and decreased hospital stays due to those medical errors. The CPOE systems are projected to increase in their prevalence as more limitations are set on the number of hours residents may work (Koppel, et al., 2005). Likewise, nursing shortages are estimated to continue to rise; therefore, such a system will be beneficial to decrease stress on employees as they struggle with managing more daily tasks and routine workload duties (Koppel, et al., 2005).

Assessment Elements to Evaluate System

There have been studies performed at various hospitals concerning the use of CPOE systems. The results of one such study at Wishard Memorial Hospital found that physicians using the systems actually decreased overall costs while increasing the orders for follow up tests that had previously been neglected at times (Doolan & Bates, 2002). Preventive care measures were also increased compared with the pre-CPOE era. Brigham and Women’s Hospital decreased their overall errors by over 55% (Doolan & Bates, 2002).

Unfortunately, positive results from research studies are not going to be the only elements used to successfully assess whether or not implementation of such a system is indicated. Physicians’ work practices are vital in the assessment as well. There is a learning curve involved with the advent of a CPOE system and sometimes physicians are not willing to put in the time and effort to learn a system when they are satisfied with the current method in use (Doolan & Bates, 2002). Another need in the assessment is the level of technology that the hospital currently has in place. As a general rule, most systems are designed to perform the functions needed from an administrative level and are not necessarily kept up to date until it is required for a new piece of equipment (Doolan & Bates, 2002). The hospital must assess whether or not there is enough technology already in place to support a CPOE system and also whether there will be support from the administration and other financial supporters.

Other Assessment Criteria

A smaller criterion in the assessment of the CPOE system is whether or not physicians will have the ability to modify to suit the needs of the hospital. It has been found that the best systems implemented are ‘homegrown’ and adaptable to the needs of the staff when at all possible. Strictly commercial systems do not have the functionality offered by these modifiable ‘homegrown’ systems (Doolan & Bates, 2002). However, if successful implementation is to be achieved, physicians will need to be satisfied with the system implemented by the administration and the administration will also need to ensure the chosen system is accepted by their physicians so as to seamlessly transition from a paper method to an electronic method.

Implementation of the CPOE Plan

It has been said by Doolan and Bates (2002) that the decision to implement a CPOE is a two-step method. The first step consists of the hospital making the decision to adopt the electronic system over the traditional paper method. The second step consists of the physicians and gaining their approval as to whether or not they will be satisfied with utilizing the technology to input their patient’s orders rather than by way of their previous process. It is because of the second step in the implementation process that providing incentives is important. If the physicians have a certain level of input in the system or can voice their opinions about what they feel is needed, they may likely be more accepting of a new form of technology, even if this means that it will take a little extra time to learn the system (Doolan & Bates, 2002).

Conclusion

The important note to consider when deciding whether or not to implement a Computerized Physician Order Entry system in the hospital or other health care institution is whether or not it will benefit patients in the long term. Studies have indicated there are more advantages to the CPOE implementation and that, if physicians support this, the plan will significantly decrease patient errors in the prescribing of medications and other patient order information. This will cut costs in hospital administration and will allow for the overall increase in the quality of patient care. Likewise, it will reduce stress levels for health care professionals and allow for one more system of checks and balances to ensure the proper care of patient delivery in general.

References

Doolan, D., & Bates, D. (2002). Computerized physician order entry systems in hospitals: Mandates and incentives. Health Affairs, 21(4), 180-188.

Koppel, R., Metlay, J., Cohen, A., Abaluck, B., Localio, A., Kimmel, S., & Strom, B. (2005). Role of computerized physician order entry systems in facilitating medication errors. Journal of the American Medical Association, 293(10), 1197-1203.

Stone, W., Smith, B., Shaft, J., Nelson, R., & Money, S. (2009). Impact of a computerized physician order-entry system. J Am Coll Surg, 208(5), 960-967.

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