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Improving patient safety using interactive, evidence-based decision support tools.

Magaret M Quinn1, Joseph Mannion

  • 1Meridian Health, Wall, New Jersey, USA. mquinn@meridianhealth.com

Joint Commission Journal on Quality and Patient Safety
|January 25, 2006
PubMed
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Computerized physician order entry (CPOE) interactive protocols improved acute myocardial infarction (AMI) guideline compliance by 10% within two months. This technology enhances patient safety and allows for data analysis for continuous improvement.

Area of Science:

  • Health Informatics
  • Clinical Decision Support Systems

Background:

  • Meridian Health implemented interactive protocols using computerized physician order entry (CPOE).
  • These protocols act as a clinical decision-support tool to enhance adherence to evidence-based guidelines.
  • Specific protocols for acute myocardial infarction (AMI) were developed to guide immediate treatment, including aspirin and beta-blocker administration, with options to document contraindications.

Purpose of the Study:

  • To evaluate the impact of interactive protocols within CPOE on guideline compliance.
  • To assess the effectiveness of clinical decision support in improving patient safety.
  • To determine the influence of CPOE on physician order patterns.

Main Methods:

  • Development and implementation of interactive protocols for acute myocardial infarction (AMI) guidelines within a CPOE system.

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  • Rollout across three Meridian hospitals, with 17 protocols in use across six care categories.
  • Monitoring of compliance rates and physician order patterns before and after implementation.

    • Main Results:

    • A 10% increase in compliance with AMI guidelines within two months of protocol implementation.
    • Sustained 100% compliance rates during months when interactive protocols were utilized.
    • A significant increase in the total number of online physician orders, up to 46% at one hospital.

    Conclusions:

    • Physicians recognize CPOE interactive protocols as valuable for improving patient safety.
    • The system facilitates analysis of usage patterns, supporting continuous process improvement.
    • Interactive protocols integrated with CPOE represent an innovative strategy for enhancing patient safety in healthcare settings.