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Using an enhanced oral chemotherapy computerized provider order entry system to reduce prescribing errors and improve
Christine M Collins1, Khaled A Elsaid
1Department of Pharmacy, Rhode Island Hospital, Providence, RI 02903, USA.
Summary
Implementing computerized provider order entry (CPOE) for oral chemotherapy significantly reduced prescribing errors. This enhances patient safety by minimizing risks associated with oral chemotherapy orders and administration.
Area of Science:
- Oncology
- Health Informatics
- Patient Safety
Background:
- Oral chemotherapy presents unique challenges in order, review, and administration.
- Prescribing errors in oral chemotherapy can lead to significant patient harm.
- Healthcare Failure Modes and Effects Analysis (HFMEA) is a valuable tool for process improvement.
Purpose of the Study:
- To decrease failures in the oral chemotherapy process.
- To reduce oral chemotherapy-related prescribing errors intercepted by pharmacists.
- To enhance patient safety in oral chemotherapy management.
Main Methods:
- A before-and-after cohort study was conducted.
- A multidisciplinary team utilized HFMEA to identify failure modes in oral chemotherapy processes.
- Computerized Provider Order Entry (CPOE) for oral chemotherapy was developed and implemented.
- Pharmacist-intercepted prescribing errors were analyzed pre- and post-CPOE implementation.
Main Results:
- HFMEA identified prescribing and administration as high-risk components.
- CPOE implementation led to a significant 69% reduction in prescribing error risk (P=0.023).
- Specific error types associated with substantial patient harm were eliminated post-CPOE.
Conclusions:
- Oral chemotherapy prescribing is a high-risk process with potential for patient harm.
- CPOE is an effective intervention for reducing oral chemotherapy prescribing errors.
- CPOE should be integrated into fail-safe processes to improve patient safety.
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