Workflow, Time Requirement, and Quality of Medication Documentation with or without a Computerized Physician Order Entry System-A Simulation-Based Lab Study.
Journal
Methods of information in medicine
ISSN: 2511-705X
Titre abrégé: Methods Inf Med
Pays: Germany
ID NLM: 0210453
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
medline:
11
5
2023
pubmed:
6
4
2023
entrez:
5
4
2023
Statut:
ppublish
Résumé
The introduction of a computerized physician order entry (CPOE) system is changing workflows and redistributing tasks among health care professionals. The aim of this study is to describe exemplary changes in workflow, to objectify the time required for medication documentation, and to evaluate documentation quality with and without a CPOE system (Cerner® i.s.h.med). Workflows were assessed either through direct observation and in-person interviews or through semistructured online interviews with clinical staff involved in medication documentation. Two case scenarios were developed consisting of exemplary medications (case 1 = 6 drugs and case 2 = 11 drugs). Physicians and nurses/documentation assistants were observed documenting the case scenarios according to workflows established prior to CPOE implementation and those newly established with CPOE implementation, measuring the time spent on each step in the documentation process. Subsequently, the documentation quality of the documented medication was assessed according to a previously established and published methodology. CPOE implementation simplified medication documentation. The overall time needed for medication documentation increased from a median of 12:12 min (range: 07:29-21:10 min) without to 14:40 min (09:18-25:18) with the CPOE system ( This study revealed that CPOE implementation simplified the medication documentation process but increased the time spent on medication documentation by 20% in two fictitious cases. This increased time resulted in higher documentation quality, occurred at the expense of physicians, and was primarily due to intravenous/subcutaneous prescriptions. Therefore, measures to support physicians with complex prescriptions in the CPOE system should be established.
Sections du résumé
BACKGROUND
The introduction of a computerized physician order entry (CPOE) system is changing workflows and redistributing tasks among health care professionals.
OBJECTIVES
The aim of this study is to describe exemplary changes in workflow, to objectify the time required for medication documentation, and to evaluate documentation quality with and without a CPOE system (Cerner® i.s.h.med).
METHODS
Workflows were assessed either through direct observation and in-person interviews or through semistructured online interviews with clinical staff involved in medication documentation. Two case scenarios were developed consisting of exemplary medications (case 1 = 6 drugs and case 2 = 11 drugs). Physicians and nurses/documentation assistants were observed documenting the case scenarios according to workflows established prior to CPOE implementation and those newly established with CPOE implementation, measuring the time spent on each step in the documentation process. Subsequently, the documentation quality of the documented medication was assessed according to a previously established and published methodology.
RESULTS
CPOE implementation simplified medication documentation. The overall time needed for medication documentation increased from a median of 12:12 min (range: 07:29-21:10 min) without to 14:40 min (09:18-25:18) with the CPOE system (
CONCLUSION
This study revealed that CPOE implementation simplified the medication documentation process but increased the time spent on medication documentation by 20% in two fictitious cases. This increased time resulted in higher documentation quality, occurred at the expense of physicians, and was primarily due to intravenous/subcutaneous prescriptions. Therefore, measures to support physicians with complex prescriptions in the CPOE system should be established.
Identifiants
pubmed: 37019150
doi: 10.1055/s-0042-1758631
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
40-48Informations de copyright
Thieme. All rights reserved.
Déclaration de conflit d'intérêts
None declared.