Computerized Provider Order Entry with Pager Notification Improves Efficiency in STAT Radiographic Studies and Respiratory Treatments

Brian R. Jacobs MD; Eric Crotty MD; Conway RRT; Kim Ward Hart; Craig Dietrich; Scott Pettinichi RRT; John Racadio MD

doi:10.4338/ACI-2009-10-RA-0004

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2010; 01(01): 19-31
DOI: 10.4338/ACI-2009-10-RA-0004

Research Article

Schattauer GmbH

Computerized Provider Order Entry with Pager Notification Improves Efficiency in STAT Radiographic Studies and Respiratory Treatments

Authors

Brian R. Jacobs MD

¹Center for Pediatric Informatics, Children’s National Medical Center, Washington DC
Eric Crotty MD

²Department of Radiology and Divisions of Respiratory Therapy and Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Conway RRT

³Divisions of Respiratory Therapy and Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Kim Ward Hart

⁴Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Craig Dietrich

⁴Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
Scott Pettinichi RRT

³Divisions of Respiratory Therapy and Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
John Racadio MD

²Department of Radiology and Divisions of Respiratory Therapy and Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Abstract

Summary

Background: The use of computerized provider order entry (CPOE) has been widely linked to improvements in patient safety. We hypothesized that electronic routing of CPOE-generated orders through individual pagers would improve the efficiency of STAT radiographic studies and respiratory treatments.

Methods: The study was conducted in two periods before and after implementing pager notification of STAT orders. In the Baseline Period, CPOE-generated STAT orders were communicated to radiology technicians or respiratory therapists through the use of printed orders, manual paging and/or telephone communication. The time to process the order and deliver a radiology result or respiratory treatment was tracked. In the Intervention Period CPOE-generated STAT orders were electronically routed to the radiology technician’s or respiratory therapist’s pager. During both time periods, clinicians completed user satisfaction surveys.

Results: Using pager notification, there was a significant reduction in radiology technician arrival time (16.8±2.1 vs 7.9±0.7 mins, p<0.001). Similarly there was a significant reduction in the cumulative time required to capture the radiographic image, image availability in the picture archiving and communication system (PACS) and the verbal report from the radiologist (p<0.05). The time required in obtaining a preliminary or final radiographic written report and the total cycle times were not significantly reduced. For STAT respiratory therapy orders there was a significant reduction in the mean time from ordering to administration of respiratory therapy treatments (124.7±14.1 vs 49.8±11.4 minutes, p<0.01). Radiologists, respiratory therapists and ordering clinicians reported improved satisfaction after implementation of pager notification.

Conclusion: Computer-generated orders for STAT radiographic studies and respiratory treatments can be carried out significantly faster through the use of direct pager notification. The implementation of this process has resulted in improved care delivery and widespread clinician satisfaction.

Keywords

Computerized provider order entry - Efficiency - Care orders - Radiology - Respiratory therapy

Full Text

References

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