According to the Institute of Medicine (IOM) in 2000, states there is an estimate of over a million injuries and nearly 100,000 deaths annually attributed to medical errors. The report differentiates between active and latent errors. Active errors occur where the frontline of the effects are noticed immediately. Latent errors result from system failures, and tend to be distant from the direct control of frontline individuals (Harrington, 2009).
Computerized Physician Order Entry (CPOE) systems are the latest tool used in relation to patient safety. These systems are a variety of computer-based systems that share common features of automating the clinical ordering process to ensure standardized, legible, and complete orders. CPOE provides an opportunity to reduce errors, improve patient safety, improve work flow efficiency, and increase quality through obtaining clinical and patient information (Rahimi, Timpka, Vimarlund, Uppugunduri & Svesson, 2009).
Currently CPOE is implemented within many Hospital Corporation of America (HCA) hospitals with minimal advance notification of change, and expectation of the program to be executed within a few weeks. Compounding this problem available resources were two nurse super users, and one emergency room educator. These individuals do not work weekends leaving the weekend shifts open for potential errors and no direction. Input from staff nurses and doctors were not included, only with the exception of the Medical Director. Senior leadership was not involved with learning the software or understanding the current culture of the department related to workflow. Classes conducted for nurses, doctors, emergency room techs were to be taken within a two week time frame. The program originally set to launch March 3, 2011 was rescheduled to begin March 31, 2011, which enhanced the learning curve by many nurses and doctors.
Unfortunately, CPOE is not just a niche computer system used by doctors and nurses; it is the cornerstone of an entire process. CPOE directly affects patient care, decision-making, pharmacy and, nursing workflows, and communication with ancillary and other disciplines. Successful transition of CPOE within any health care organization requires workflows to be analyzed and post implementation to be modified. Specific policies and processes should be developed specific to the department for managing the transition from handwriting to computerized ordering, and documentation. Many doctors and nurses converting from handwriting to computer ordering, and charting requires a substantial change and redefining one’s work habits. Clinical and senior administration involvement with CPOE must be evident to staff members. Adopting Physician Champions, who believe in the CPOE system, will help curtail human-machine errors (First Consulting Group, 2003, p 16).
According to the article Organization-Wide Adoption of Computerized Provider Order Entry Systems study states, although CPOE...