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Updated: May 29, 2026

Improving IV Insulin Administration in a Community Hospital

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

The shift in workarounds upon implementation of computerized physician order entry.

Heleen Van Der Sijs¹, Irene Rootjes, Jos Aarts

¹Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.

Studies in Health Technology and Informatics

|September 7, 2011

Summary

Workarounds are common in healthcare, persisting even after implementing computerized physician order entry (CPOE) systems. This study found that new workarounds emerged, while some old ones remained, in both paper and electronic prescribing environments.

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Area of Science:

Healthcare systems research
Clinical informatics
Patient safety

Background:

Workarounds are deviations from formal processes to improve workflow or bypass issues.
Previous studies concentrated on workarounds in medication use post-computerized physician order entry (CPOE) implementation.
Understanding workaround dynamics is crucial for optimizing healthcare processes.

Purpose of the Study:

To investigate the presence and nature of workarounds in both paper-based and electronic prescribing systems.
To analyze changes in workarounds following the implementation of CPOE.
To identify persistent and newly emerged workarounds in a hospital setting.

Main Methods:

Comparative analysis of workarounds in two hospital wards.
Observation and documentation of workarounds in paper-based prescribing.
Assessment of workarounds in electronic prescribing systems after CPOE implementation.

Main Results:

Workarounds were identified in both paper-based and electronic prescribing systems.
Following CPOE implementation, some pre-existing workarounds disappeared, while others persisted.
New workarounds emerged in the electronic prescribing system after CPOE implementation.

Conclusions:

Workarounds are an inherent aspect of healthcare workflows, regardless of the system used.
CPOE implementation does not eliminate workarounds but can alter their form and prevalence.
Further research is needed to understand and mitigate the impact of workarounds on patient safety and system efficiency.