Faster, clearer, safer orders

What is Clinical & Systems Transformation trying to achieve? – part 3

handwriting that could say either Avandia or CoumadinDoes this say Avandia or Coumadin?

“You could pull up multiple examples of errors caused by illegible handwriting,” says Dr. Alain Gagnon, CST Chief Medical Information Officer (PHSA).

CST will counter this problem by implementing computerized provider order entry (CPOE).

“Essentially, that means that providers (physicians, midwives, nurse practitioners, clinical pharmacists and dentists) will enter their orders electronically rather than writing them on paper and having them transcribed,” explains Dr. Gagnon.

As a result, pharmacists, technicians, nurses and other clinicians will be able to:

  • Receive the order immediately
  • Read the order clearly; and
  • Receive orders from providers located anywhere, even off-site.

Dr. Alain Gagnon“It will expedite processing,” states Dr. Gagnon. “The time from ordering a medication to administering will be greatly decreased. Lab tests too – it won’t cut wait lists, but it will decrease processing time, meaning that you can get urgent requests through quicker.

“We can also increase patient safety by introducing checks and balances at the point of order entry, rather than relying on checks that come later,” he adds. “Such tools allow you to rely less on your recollection of events, and you can use your brain for other things.”

For many common diagnoses, providers will be able to use pre-approved order sets.

“Using order sets makes entering orders into the computer easier,” says Dr. Gagnon. “It allows you to pre-select from a catalogue of key things, making it faster to use CPOE. It also enables standardization, such as reminders to order a certain test, or even making a test mandatory. There are many examples of improvements that come from standardization, but an example from my own field (although this was not using CPOE) was that we decreased severe adverse maternal outcomes from pre-eclampsia from 3.1% to 1.9% by using standardized order sets for the condition.”

Order sets can be tweaked to suit the individual needs of a patient, and you can save these amended sets as ‘favourites’ to use again.

Did you know?

Studies of computerized provider order entry (CPOE) have shown:

1. http://www.leapfroggroup.org/media/file/Leapfrog-AHA_FAH_CPOE_Report.pdf 
2. University of Pittsburgh Medical Center

If you have questions or feedback please email info@CSTproject.ca.

See also What is Clinical & Systems Transformation trying to achieve? – part 1, and Information at your fingertips: what is Clinical & Systems Transformation trying to achieve? – part 2.

You can also download a printable version of this article: Faster, clearer, safer orders (PDF)