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Related Concept Videos

Types of Reports III: Telephone and Verbal Reports01:26

Types of Reports III: Telephone and Verbal Reports

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Charting by Exception, or CBE, is a method of documentation used in healthcare, particularly in nursing, that focuses on documenting only significant or abnormal findings rather than recording every detail. This approach aims to streamline the documentation process, improve efficiency, and ensure that healthcare providers can quickly identify deviations from normalcy in patient assessments.
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Methods of Documentation III: PIE01:21

Methods of Documentation III: PIE

Problem-intervention-evaluation (PIE) is a systematic approach to documentation used in healthcare settings for clinical decision-making and patient care planning. It is a structured approach to organizing patient data based on problems, interventions, and evaluations. Here's a breakdown of its key features and considerations:

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Related Experiment Video

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Improving IV Insulin Administration in a Community Hospital
12:08

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Embedding time-limited laboratory orders within computerized provider order entry reduces laboratory utilization.

Natalie M Pageler1, Deborah Franzon, Christopher A Longhurst

  • 1Center for Excellence in Pulmonary Biology Divisions of Pulmonary, Asthma and Critical Care Medicine, Stanford, CA, USA. npageler@stanford.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|February 27, 2013
PubMed
Summary
This summary is machine-generated.

Implementing computerized provider order entry limits on laboratory tests significantly reduced utilization. This strategy decreased complete blood cell counts, chemistry, and coagulation studies without impacting patient outcomes.

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Area of Science:

  • Clinical Informatics
  • Laboratory Medicine
  • Healthcare Management

Background:

  • Laboratory utilization is a significant component of healthcare costs and can contribute to iatrogenic complications.
  • Computerized provider order entry (CPOE) systems offer opportunities to optimize clinical workflows and resource management.

Purpose of the Study:

  • To evaluate the impact of implementing CPOE-based order entry limits on the utilization of repeating laboratory studies.
  • To determine if these limits affect patient outcomes such as mortality and length of stay.

Main Methods:

  • A cohort study with historical controls was conducted in a 20-bed pediatric intensive care unit (PICU).
  • The study compared laboratory utilization before (n=818 discharges) and after (n=1,021 discharges) the implementation of a CPOE rule limiting repeating laboratory tests to a 24-hour interval.

Main Results:

  • The intervention led to significant decreases in the number of complete blood cell counts, chemistry panels, and coagulation studies per patient day.
  • Postintervention, tests per patient day decreased from 1.5 to 1.0 for CBCs, 10.6 to 6.9 for chemistry, and 3.3 to 1.7 for coagulation (p < 0.01 for all).
  • Regression analysis confirmed the intervention's effectiveness in reducing laboratory utilization, even after accounting for preintervention trends.

Conclusions:

  • Limits on laboratory orders within CPOE effectively decrease laboratory utilization.
  • This strategy did not adversely affect patient mortality or length of stay.
  • Wider adoption could potentially reduce healthcare costs, iatrogenic anemia, and catheter-associated bloodstream infections.