OBJECTIVE To reduce the probability of failure in the oral chemotherapy order, review and administration process and to reduce oral chemotherapy-related prescribing errors intercepted by clinical pharmacists prior to reaching the patient. DESIGN A before-and-after cohort study. SETTING A 719-bed multidisciplinary tertiary care institution with a pediatric division and an outpatient cancer c...

Background: One way to reduce medical errors associated with physician orders is computerized physician order entry (CPOE) software. This study was conducted to compare prescription orders between 2 groups before and after CPOE implementation in a hospital. Methods: We conducted a before-after prospective study in 2 intensive care unit (ICU) wards (as intervention and control wards) in the larg...

Selecting the right types and quantities of computers to support data entry to an inpatient Electronic Medical Record (EMR) can be challenging. In addition to software and hardware considerations, many other variables affect the decision including staffing levels, hospital workflows, and floor plans. Rush University Medical Center (RUMC) developed a tool to help identify the quantity of devices...

S t u d y s e l e c t i o n a n d a s s e s s m e n t Studies were selected if they were randomized controlled trials (RCTs), nonrandomized controlled trials, or observational studies with controls that evaluated CPOE or CDSSs for reducing medication errors, and measured clinical (any measure of morbidity or mortality including adverse drug events) or surrogate (observed errors and intermediate...

OBJECTIVES Duplicate laboratory tests that are unwarranted increase unnecessary phlebotomy, which contributes to iatrogenic anemia, decreased patient satisfaction, and increased health care costs. MATERIALS AND METHODS We employed a clinical decision support tool (CDST) to block unnecessary duplicate test orders during the computerized physician order entry (CPOE) process. We assessed laborat...

This paper provides a systematic literature review of CPOE evaluation studies in the outpatient setting on: safety; cost and efficiency; adherence to guideline; alerts; time; and satisfaction, usage, and usability. Thirty articles with original data (randomized clinical trial, non-randomized clinical trial, or observational study designs) met the inclusion criteria. Only four studies assessed t...

This study empirically examines the association between hospital inefficiency and the decision to introduce electronic medical records (EMR) and computerized physician order entry (CPOE) in a national sample of U.S. general hospitals in urban areas in 2006. The main research question is whether the presence of hospital cost inefficiency or other factors driving inefficiency in the production pr...

BACKGROUND Computerized physician order entry (CPOE) systems are designed to increase safety and improve quality of care; however, their impact on efficiency in the ED has not yet been validated. This study examined the impact of CPOE on process times for medication delivery, laboratory utilization and diagnostic imaging in the early, late and control phases of a regional ED-CPOE implementation...

OBJECTIVE To identify the distinctive contributions of high-reliability theory (HRT) and normal accident theory (NAT) as frameworks for examining five patient safety practices. DATA SOURCES/STUDY SETTING We reviewed and drew examples from studies of organization theory and health services research. STUDY DESIGN After highlighting key differences between HRT and NAT, we applied the frames to...

BACKGROUND Potentially inappropriate medication (PIM) use in hospitalized older patients is common. Our objective was to determine whether a computerized provider order entry (CPOE) drug warning system can decrease orders for PIMs in hospitalized older patients. METHODS We used a prospective before-and-after design among patients 65 years or older admitted to a large, urban academic medical c...