CPOE and Order Tracker: Improving Workflow and Communication of Laboratory Orders in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162999
Type:
Presentation
Title:
CPOE and Order Tracker: Improving Workflow and Communication of Laboratory Orders in the Emergency Department
Abstract:
CPOE and Order Tracker: Improving Workflow and Communication of Laboratory Orders in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Rudge, Nancy, BSN, RN, CCRN
P.I. Institution Name:Vanderbilt University Medical Center
Contact Address:1009 Oxford House, Nashville, TN, 37232 -4740, USA
Contact Telephone:(615) 936-2906
Clinical Topic: In an emergency department (ED), rapid patient turnover and critically ill patients who require numerous stat procedures and tests necessitate timely, accurate, and concise communication among members of the health care team. The manual processes for communication of patient status and orders notification are riddled with potential for errors and delays in patient care. Potential problems identified at this emergency department included: (1) Illegible orders; (2) Transcription errors, including incorrect patient name and test on manual lab requisitions; (3) Collection errors, such as inadequate volume, incorrect container, and wrong preparation; and (4) Unclear order status resulting in the team not knowing if the order was initiated, in progress, completed, and/or resulted. Several technological improvements were implemented at this emergency department to address these issues. Through successful adaptation and adoption of electronic tools, such as computerized provider order entry (CPOE), ED Whiteboard, and Order Tracker?an application for order documentation and tracking?this emergency department minimized errors, improved workflow, and enhanced communication. Implementation: The whiteboard is the communication hub in the emergency department. Our electronic version, ED Whiteboard, was created to mimic the manual whiteboard process and facilitate communication about patient flow in the emergency department. An interdisciplinary team of nurses, physicians, biomedical informaticians, and system support specialists led the development and implementation of a customized version of the CPOE system and the Order Tracker application, which were embedded in the ED Whiteboard. This single point of entry allowed clinicians to enter orders and included several features, such as visual alerts for new orders, information on status of orders, and results from patients' electronic medical record. Feedback sessions with nurses, physicians, ancillary staff, and management enabled refinement of applications and workflow. Outcomes: Prior to implementation, there were multiple steps from lab order initiation to electronic results. CPOE, ED Whiteboard, and Order Tracker decreased these steps by 33% while improving collection time and decreasing delays in sending specimens to the lab. Because electronic orders were legible and correct patient-specific lab requisitions were automatically printed, transcription errors were reduced. Bar coding on requisitions eliminated keystroke mistakes by laboratory staff. Workstations strategically placed throughout the emergency department gave staff easy access to order status. With one click, staff could view the time the order was acknowledged and the time the specimen was collected and sent. Recommendations: The electronic communication among all levels of caregivers increased the continuity of patient care and decreased time spent tracking information. Electronic information systems such as CPOE, ED Whiteboard, and Order Tracker can be useful in improving work processes and communication when adaptation and adoption are successful.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCPOE and Order Tracker: Improving Workflow and Communication of Laboratory Orders in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162999-
dc.description.abstract<table><tr><td colspan="2" class="item-title">CPOE and Order Tracker: Improving Workflow and Communication of Laboratory Orders in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Rudge, Nancy, BSN, RN, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Vanderbilt University Medical Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1009 Oxford House, Nashville, TN, 37232 -4740, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(615) 936-2906</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Nancy.k.rudge@vanderbilt.edu</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: In an emergency department (ED), rapid patient turnover and critically ill patients who require numerous stat procedures and tests necessitate timely, accurate, and concise communication among members of the health care team. The manual processes for communication of patient status and orders notification are riddled with potential for errors and delays in patient care. Potential problems identified at this emergency department included: (1) Illegible orders; (2) Transcription errors, including incorrect patient name and test on manual lab requisitions; (3) Collection errors, such as inadequate volume, incorrect container, and wrong preparation; and (4) Unclear order status resulting in the team not knowing if the order was initiated, in progress, completed, and/or resulted. Several technological improvements were implemented at this emergency department to address these issues. Through successful adaptation and adoption of electronic tools, such as computerized provider order entry (CPOE), ED Whiteboard, and Order Tracker?an application for order documentation and tracking?this emergency department minimized errors, improved workflow, and enhanced communication. Implementation: The whiteboard is the communication hub in the emergency department. Our electronic version, ED Whiteboard, was created to mimic the manual whiteboard process and facilitate communication about patient flow in the emergency department. An interdisciplinary team of nurses, physicians, biomedical informaticians, and system support specialists led the development and implementation of a customized version of the CPOE system and the Order Tracker application, which were embedded in the ED Whiteboard. This single point of entry allowed clinicians to enter orders and included several features, such as visual alerts for new orders, information on status of orders, and results from patients' electronic medical record. Feedback sessions with nurses, physicians, ancillary staff, and management enabled refinement of applications and workflow. Outcomes: Prior to implementation, there were multiple steps from lab order initiation to electronic results. CPOE, ED Whiteboard, and Order Tracker decreased these steps by 33% while improving collection time and decreasing delays in sending specimens to the lab. Because electronic orders were legible and correct patient-specific lab requisitions were automatically printed, transcription errors were reduced. Bar coding on requisitions eliminated keystroke mistakes by laboratory staff. Workstations strategically placed throughout the emergency department gave staff easy access to order status. With one click, staff could view the time the order was acknowledged and the time the specimen was collected and sent. Recommendations: The electronic communication among all levels of caregivers increased the continuity of patient care and decreased time spent tracking information. Electronic information systems such as CPOE, ED Whiteboard, and Order Tracker can be useful in improving work processes and communication when adaptation and adoption are successful.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:48Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:48Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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