废弃的住院订单:提高CPOE安全性和效率的机会
Anne Grauer1,2, Yuyang Yang3, Jo Applebaum2
1Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States.
Applied clinical informatics
|January 30, 2026
概括
药物订单放弃在电子健康记录 (EHR) 中很常见,影响了患者的安全. 频繁的重新排序表明工作流的问题,而不是取消,强调了需要改进CPOE系统的需要.
科学领域:
- 医疗信息学 医疗信息学
- 患者安全 患者安全
- 临床工作流分析分析
背景情况:
- 废弃的药物订单,启动但未签署,构成安全风险,并表明电子健康记录 (EHR) 的低效率.
- 了解药物订单放弃对于优化医疗保健和患者安全至关重要.
研究的目的:
- 探索两种不同的医疗保健系统与不同的EHR的住院药物订单放弃率和特征.
- 确定与药物订单放弃相关的因素,包括临床医生,患者和订单特定变量.
主要方法:
- 在两个三级医疗保健系统中,无声警报识别了废弃的药物订单 (已启动但未在24小时内签署).
- 分析了超过680万份药品订单的数据,计算了废弃和重新订购率.
- 回归模型检查了放弃和各种特征之间的关联;指数模型特征重新排序时间表.
主要成果:
- 遗弃率在第1站点为11.2%,第2站点为25.0%.
- 超过一半的废弃订单是在24小时内重新订购的 (65.3%网站1;54.2%网站2).
- 放弃率因患者年龄 (在儿童中更高),临床医生的资历 (临床医生的次数较少) 和工作量 (在更多独特的患者中更高) 而有所不同.
结论:
- 订单放弃很普遍,受患者年龄,临床医生的经验和工作量的影响.
- 频繁的重新排序表明工作流中断,而不是取消,对放弃有很大的贡献.
- 放弃药物订单可以作为提高电子病历功能,临床医生工作流程和患者安全的指标.
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