Physician-Nurse Communication Surrounding Computerized Physician Order Entry Systems From Social and Technical...

Area of Science:

• Health Informatics
• Sociotechnical Systems
• Medical Communication

Background:

• Computerized physician order entry (CPOE) systems enhance order transmission and patient safety.
• Over-reliance on CPOE can negatively impact communication between healthcare professionals.
• Understanding the sociotechnical factors influencing CPOE use is essential for optimizing its benefits.

Purpose of the Study:

• To explore physician-nurse communication dynamics within the context of computerized physician order entry systems.
• To analyze the influence of sociotechnical factors on the effectiveness of CPOE in a tertiary teaching hospital.

Main Methods:

• An ethnographic study was conducted involving 89 hours of participant observation.
• Semistructured interviews were held with seven nurses and five physicians.
• Relevant documents and artifacts were collected to supplement observational data.

Main Results:

• CPOE quality issues, including usability problems and poor interoperability, reduced work efficiency.
• Social factors such as inadequate training and unclear responsibilities exacerbated communication challenges.
• Environmental factors like spatial/temporal separation and insufficient technical support hindered problem resolution.

Conclusions:

• Both technical and social contextual factors of CPOE systems significantly impact physician-nurse communication.
• Cognitive issues and alert fatigue within CPOE systems were major contributors to reduced work efficiency.
• Enhancements in CPOE functionality and interprofessional communication training are necessary to optimize healthcare collaboration.