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An electronic safety screening process during inpatient computerized physician order entry improves the efficiency of
Erika Schneider1, Paul Ruggieri, Lauren Fromwiller
1Imaging Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, USA.
Rationale And Objectives:
Delays between order and magnetic resonance (MR) exam often result when using the conventional paper-based MR safety screening process. The impact of an electronic MR safety screening process imbedded in a computerized physician order entry (CPOE) system was evaluated.
Materials And Methods:
Retrospective chart review of 4 months of inpatient MR exam orders and reports was performed before and after implementation of electronic MR safety documentation. Time from order to MR exam completion, time from MR exam completion to final radiology report, and time from first order to final report were analyzed by exam anatomy. Length of stay (LOS) and date of service within the admission were also analyzed.
Results:
We evaluated 1947 individual MR orders in 1549 patients under an institutional review board exemption and a waiver of informed consent. Implementation of the electronic safety screening process resulted in a significant decrease of 1.1 hours (95% confidence interval 1.0-1.3 hours) in the mean time between first order to final report and a nonsignificant decrease of 0.8 hour in the median time from first order to exam end. There was a 1-day reduction (P = .697) in the time from admission to the MR exam compared to the paper process. No significant change in LOS was found except in neurological intensive care patients imaged within the first 24 hours of their admission, where a mean 0.9-day decrease was found.
Conclusion:
Benefits of an electronic process for MR safety screening include enabling inpatients to have decreased time to MR exams, thus enabling earlier diagnosis and treatment and reduced LOS.
Insights
Implementing electronic MR safety screening in computerized physician order entry systems significantly reduces delays for inpatient MRI exams. This streamlines the process, enabling faster diagnosis and treatment for patients.
Area of Science:
- Radiology
- Medical Informatics
- Patient Safety
Background:
- Conventional paper-based MR safety screening leads to significant delays between exam orders and completion.
- These delays can impede timely diagnosis and treatment for inpatients requiring MR imaging.
Purpose of the Study:
- To evaluate the impact of integrating an electronic MR safety screening process into a computerized physician order entry (CPOE) system.
- To assess the effect of this electronic system on the time from MR exam order to completion and subsequent reporting.
Main Methods:
- Retrospective chart review of inpatient MR exam orders and reports before and after electronic safety documentation implementation.
- Analysis of time intervals including order to exam completion, exam completion to final report, and first order to final report.
- Evaluation of length of stay (LOS) and date of service within admission.
Main Results:
- Electronic screening significantly decreased the mean time from first order to final report by 1.1 hours.
- A nonsignificant decrease of 0.8 hour was observed in the median time from first order to exam end.
- A 1-day reduction in time from admission to MR exam was noted, with a significant 0.9-day decrease in LOS for neurological intensive care patients within 24 hours of admission.
Conclusions:
- Electronic MR safety screening integrated with CPOE systems reduces inpatient MR exam turnaround times.
- This improved efficiency facilitates earlier diagnosis and treatment initiation.
- The electronic process contributes to reduced length of stay for specific patient populations.
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