Difference between revisions of "Default settings of computerized physician order entry system order sets drive ordering habits"
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Revision as of 04:45, 1 October 2015
Article Review
Introduction
Computerized physician order entry (CPOE) sytems are quickly becoming widely used and groups of orders ("order sets") to allow for easy order input are a common feature. Order sets are groups of orders commonly used in for condition-specific or situation specific encounters. The order set components (specific order) can be set up to be "preselected" or "defaulted-on" whenever the order set is used while other components might be "optional" or "defaulted-off". Physicians create order habits based on their needs and incorporate order sets to their workflow of practice.[1]
Methods
Order set for post transfusion orders were utilized for this study in an effort to improve quality. Changes to two orders were done; posttransfusion hematocrits and platelet count were modified from "optional" to "preselected". The default settings for platelets count was later changed back to "optional", allowing for a natural experiment to study the effect of the default selections of an order set on clinician ordering habits.
Results
- Initial percentage:
hematocrits orders 8.3% platelets count orders 7%
- After default order set change
hematocrits orders 57.4% platelets count orders 59.4%
- Platelet count order changed back to initial set up
platelet count orders 7.5%
There was a significant difference in the rate at which posttransfusion counts were obtained between the intervention periods and when the platelet count was defaulted "optional" and "preselected".[1]
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