Healthcare organizations can increase the likelihood of CPOE implementation success by understanding and addressing gaps in CPOE readiness. Stablein et al. developed a CPOE readiness assessment tool that helps one assess the 1) external environment, 2) organizational leadership, structure, and culture, 3) care standardization, 4) order management, 5) access to information, 6) information technology composition, and 7) infrastructure.
They validated their tool on 17 hospitals (bed size ranged from 75-906 beds). They found significant gaps in all the hospitals examined. They believe that identifying these gaps and addressing them before CPOE implementation can reduce risks.
Some good questions to ask and answer before implementing:
1. Are the goals of the staff, administration, nursing and ancillary personnel aligned? 2. how supportive is the senior administration? 3. how much clinician involvement is there? 4. how effective is communication within the facility? 5. what are the access needs? (pc’s, mobile carts, wireless network, etc) 6. what is in place with respect to education and support? 7. how clearly are workflow designs understood? And new processes designed? 8. what content is present, desired, designed? (e.g., order sets) 9. what strategies are in place for activation and support? 10. what metrics are available currently, and post activation? 11. What mechanisms does the facility have in place to achieve the clinical transformation? 12. is this an IT project (read: if it fails, it’s IT’s fault), or is this an institutional project (read: if this succeeds, everyone wins)?
Stablein D, Welebob E, Johnson E, Metzger J, Burgess R, Classen DC. Understanding hospital readiness for computerized physician order entry. Jt Comm J Qual Saf. 2003 Jul;29(7):336-44.