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Improving IV Insulin Administration in a Community Hospital

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Published on: June 11, 2012

Lessons from a successful implementation of a computerized provider order entry system.

Brian R Jacobs¹, Craig K Hallstrom, Kim Ward Hart

¹Children's National Medical Center, Washington, DC.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG

|October 12, 2012

Summary

Implementing electronic health records (EHRs) presents challenges like communication issues and order loss. Careful planning and rapid problem-solving are crucial for successful EHR adoption and improved patient safety.

Keywords:

Challenges Computerized Order Entry Medication Errors Prescribing

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Published on: August 1, 2019

Area of Science:

Health Informatics
Clinical Systems Implementation
Patient Safety Research

Background:

Electronic Health Records (EHRs) offer benefits in patient safety, care efficiency, and cost-effectiveness.
Cincinnati Children's Hospital Medical Center (CCHMC) implemented an Integrating Clinical Information System (ICIS) with Computerized Provider Order Entry (CPOE).

Purpose of the Study:

To review unanticipated challenges encountered during the ICIS implementation at CCHMC.
To identify solutions and lessons learned from the EHR implementation process.

Main Methods:

Analysis of user-generated feedback reports within the ICIS.
Categorization of feedback based on the root cause of identified issues.
Inclusion of recurring problems or those with potential for patient harm.

Main Results:

Nine distinct challenges were identified, including communication deterioration, excessive alerts, medication discontinuation issues, and order loss.
Other challenges involved error amplification, unintentional order generation, and incorrect clinician assignment for verbal orders.

Conclusions:

Unanticipated challenges are inherent in EHR implementation.
Implementation plans must include rapid methods for problem identification, evaluation, and repair.
Lessons learned can help other institutions avoid pitfalls and ensure successful EHR adoption for improved patient care.