During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left room for error due to misreading bad handwriting, confusing medications with similar names, etc.
Emory Healthcare is part of the Emory University School of Medicine in Georgia. Emory Healthcare system is comprised of multiple inpatient hospitals and clinics within the state of Georgia. In response to the studies done in 2009 Emory rolled out the CPOE system in its inpatient units to try and reduce the number of errors occurring within their system. The COPE project at Emory Healthcare was thoroughly studied to understand the basic requirements needed by Emory prior to developing the system. While much went according to plan with the roll-out of the CPOE system, there were however several problems that Emory experienced in putting the system in place.
The pros of the CPOE system included that the prescribing of wrong medications was reduced, there were fewer errors with the patient’s basic information, orders for lab work, blood work, and medications were standardized; and mistakes in the ordering...
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...ion in general. They should also set reasonable and easily obtainable goals for the new users so they can feel confident about their abilities to learn the new system.
They should also have more support staff available to assist with patients moving from surgery to post-anesthesia care. They should also offer additional training to the doctors from the community that use EMHU, although some of these physician are familiar with a CPOE type system more training would help stave off any additional problems with new users in the system.
The users that are already competent with the CPOE system (nurses, pharmacists, doctors) should be more vocal about the benefits of the system, and how because of it they now having more time to manage their patients well being. They must also speak up about what is not working in the system as so improvements can continue to be made.
All in all, for EMC to survive in a competitive environment the administrative staff at the hospital will need to re-evaluate the services they want to offer and what population demographics it will serve to better their organization.
Springfield General Hospital (SGH) is committed to high quality healthcare for patients, and providing tools to support physicians, nurses and pharmacists. SGH leadership approved the computerized physician order entry (CPOE) system as a solution to reduce prescription errors, and the results of the CPOE project are disappointing. The data show increased prescribing errors after implementing the CPOE; resulting in increased costs for adverse drug events, rather than the planned cost reduction (Spector, 2013). This change management plan provides the SGH board of directors and executive management team pragmatic steps to increase quality for patients by assessing the root issue of hospital
Healthcare organizations must inhere a strategy to stay ahead of their competitors so that they can maintain their patient volume. By measuring the quality of care through performance, patient satisfaction, and experience, and cost all play a role of having patients to choose your hospital. Today, many healthcare organizations have adopted the triple aim strategy of great quality, great patient experience for a reasonable cost. With the tracking of their patient experience and continuously improving the quality of care at a reasonable cost to stay one step ahead of their competitors and to maintain and increase patient volume has been successful help in the healthcare
This technology assist the nurse in confirming patients identify by confirming the patients’ dose, time and form of medication (Helmons, Wargel, & Daniels, 2009). Having an EHR also comes with a program that allows the medical staff to scan medications so medication errors can be prevented. According to Helmons, Wargel, and Daniels (2009) they conducted an observational study in two medical –surgical units one in the medical intensive care (ICU) and one in the surgical ICU. The researchers watched 386 nurses within the two hospitals use bar code scanning before they administrated patients’ medications. The results of the research found a 58 % decrease in medication errors between the two hospitals because of the EHR containing a bar code assisted medication administration
Nurses were the professional group who most often reported medication errors and older patients were those most often affected in the medication errors reports analyzed for this study (Friend, 2011). Medication error type’s revealed omitted medicine or dose, wrong dose, strength or frequency and wrong documentation were the most common problems at Site A where the traditional pen and paper methods of prescription were used; and wrong documentation and omission were the most common problems associated with medication errors at Site B where the electronic MMS was introduced (Friend, 2011). Reports of problems such as wrong drug, wrong dose, strength or frequency, quantity, wrong route, wrong drug and omitted dose were less frequent at Site B (Friend, 2011). The reduced incidence of omission errors at Site B supports suggestions that an advantage of the MMS is easy identification of patient requirements at each drug round time slot. Despite the finding of less omission errors at site B where the MMS had been introduced, there was a relatively high frequency in the incident reports of medication errors related to both omission and wrong dose, strength and frequency at both sites (Friend, 2011).
Medical errors are the third leading cause of death in the United States, which costs billions of dollars to the economy and increases our health care costs. How can health care managers decrease medical errors to improve costs of health care and costs to the economy? One approach is to have stricter health care polices, as it pertains to providing quality of care to patients no matter if the patient has private insurances, government insurance, self-pay, etc. the quality provided to patients should be the same across the board no matter the income class of patients, high quality of care should be our priority. The second approach would be to have stricter accountability for those that work in the health care field and make them responsible for their health care facilities and have penalties that are sanctioned for preventable medical errors.
The practice of evaluation is done to uncover empirical data that will guide decision-making and enhance the knowledge base on the topic of interest. The first, and arguably most important step in conducting an evaluation is determining the perspective from which data will be gathered. Several approaches exist and there is never a right or wrong method; however, predefining the evaluation objectives is crucial to discovering relevant conclusions (Friedman & Wyatt, 2006). Since this evaluation is occurring prior to implementation and is aimed at improving workflow, the desired goal is obtaining clinicians’ perceptions of usability of the most critical components of the CPOE.
Greiver, M., Barnsley, J., Aliarzadeh, B., Krueger, P., Moineddin, R., Butt, D. A., & ... Kaplan, D. (2011). Using a data entry clerk to improve data quality in primary care electronic medical records: a pilot study. Informatics In Primary Care, 19(4), 241-250.
increases in patient satisfaction, which in a hospital setting is important not only for our
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread publicity has helped build awareness of e-prescribing’s role in enhancing patient safety. Although it has not been in practice for very long, e-prescribing has already made a positive impact in the field of health care.
Computerized Physician Order Entry (CPOE), is also known as Computerized Provider Order Management (CPOM). CPOE is a process of automated or electronic entry record of health care physician on different types of instructions on how to treat patients, especially patients that are hospitalized under a physician’s care. CPOE is one of the most remarkable system that is being used in the healthcare system to effectively reduce the amount of medication errors. The University of Health Care System might be in the process of rolling out the CPOE portion out of the EMR project, however, they did not do a thorough investigation on what CPOE is and whether or not it would have a positive impact on the EMR project. They should have not taken the step to start the project without already knowing the basics of CPOE. They might have had thought that since it is a computerized system everything would turn out okay and there would not be any problems. However, they fall short to recognize that the user’s knowledge and experience with using the CPOE system would have a significant influence on the effectiveness and productivity of the actual system.
Patient safety is one of the most important issues in the clinical area. CPOE system has been recognized as highly tools to increase the efficiency and effectiveness of the clinical work CPOE system can provide a patient safety environment to the clinical area. And the CPOE system not only can provide patient safety in the clinical area such as prescription and order other drug, but also it can improve the model of workflow. CPOE system also can help the organization to change the work process for example monitor and coordinate the flow.
One of many nationwide initiatives to help reduce the occurrence of unnecessary medical errors and adverse events is the use of the integrated Clinical Decision Support System (CDSS). A CDSS is a system that provides the right information to the right person in a right format through a right channel at the right time of workflow to facilitate better decision-making by clinicians, reduce errors, and also to prevent adverse events (AHRQ, 2008). This proposal is a case based CDSS system that provides point of care clinical decision support, ensures five rights of medication administration (right person, right drug, right dose, right time and right route), and is designed to prevent or reduce the occurrence errors and adverse events at Perpetual Order of Saints Hospital (POSH).
I was also responsible for monitoring medication orders and reviewing patient profiles to ensure that the proper drugs and dosages were prescribed and that the pharmacy technician had prepared them properly. In many instances there were mistakes made in the preparation phase and sometimes even before, with incorrect dosages or drugs being prescribed and prepared, which could result in serious adverse effects for the patient. A clinical pharmacist’s role, however, is to make sure that these mistakes never reach the
• Handwriting interpretation errors are estimated to cause 9% of all medication errors. Although electronic prescribing (e-Rx) is finally well underway in the United States, it has for several years been the norm in many European countries. As recommended by the federal government and other national health care improvement organizations, the use of electronic prescribing applications in pediatric practice should be encouraged. The Institute of Medicine has recommended that all prescriptions be written electronically by the year 2010. It is estimated that 20% of U.