Community hospitals are succeeding with computerized physician order entry (CPOE), both in gaining physician participation and in addressing the gaps in safety and quality they were targeting, according to the report Computerized Physician Order Entry: Lessons from the Field.
As part of their efforts to improve patient safety, many hospitals in the United States are in various stages of implementing CPOE, a process in which physicians write their orders for hospital patients in the computer. The attention now focused on CPOE follows the recommendation of the Institute of Medicine report, To Err Is Human: Building a Safer Healthcare System, which has been reinforced by The Leapfrog Group, Senate Bill 1875 in California, and many other safety initiatives around the country.
CPOE is still new to the hospital industry, with much of the experience in academic medical centers. According to CHCF Program Officer Jennifer Eames, "Roughly nine out of ten hospitals in the United States are community hospitals where community practice physicians, rather than residents, must learn to write their orders electronically. This is why it is so important to focus on the challenges and success factors in the community hospital."
The report, cosponsored by California HealthCare Foundation (CHCF) and First Consulting Group (FCG) (NASDAQ: FCGI), reviews approaches taken in ten different community hospitals, as well as the observations of CPOE implementation specialists from five CPOE software vendors who have assisted multiple hospitals.
Hospitals have struggled with engaging physicians in CPOE because of the effort required to master a new way of doing their work and the reality that electronic order writing takes more time than pen and paper. "One of the central questions about CPOE in the community hospital is how to frame hospital policy, and whether to enforce expectations regarding physician use of CPOE," reports Jane Metzger, research director of emerging practices at FCG and lead author of the study.
The process of achieving universal physician adoption was reviewed with physician and project leaders in the ten community hospitals in the study. They reported working toward universal adoption over time, building the case that CPOE is the right thing to do and working within the professional culture, rather than starting with a mandate. The report also details how some hospitals have tackled the changes surrounding incorporating CPOE into the complex process of order management throughout the hospital. Every order, nursing unit, and all of the individuals and departments that respond to orders are involved. The report provides practical advice about how the hospitals built accountability, organized the project, and designed and staged a successful rollout.
Implementing CPOE throughout the hospital represents a big investment at a time when resources are scarce. "We applaud efforts such as this to assemble practical advice that will help the industry with its work on improving patient safety," observes Suzanne Delbanco, executive director of The Leapfrog Group, an employer coalition that is recommending CPOE as one of three interventions to improve safety in the nation's hospitals.
The full report is available online through the link below.
About First Consulting Group
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