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I. Gladding

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  • OS28 - Bringing Mental Health to the Forefront (ID 46)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
    • OS28.02 - Physician Adoption of Standardized Order Sets and Electronic Order Entry (ID 106)

      I. Gladding, Quality, Trillium Health Partners; Mississauga/CA

      • Abstract
      • Slides

      Purpose/Objectives: Prescription errors and unexplained prescriber variation within hospital practice greatly contributes to adverse drug events that lead to potential safety incidents. Patient safety initiatives at other institutions prioritized reducing these occurrences and out of these initiatives, electronic-order entry has demonstrated a significantly decrease adverse drug events. The multi-site structure of Trillium Health Partners (THP) fosters different physician cultures, practices and protocols between sites. Standardization of physician order sets across the three locations will decrease prescriber variation and provide a standardized patient experience. The Clinical Order Sets, Technology and Standardization (COTS) project aims to harmonize order sets and embed these in an electronic-order application while promoting physician adoption of the new electronic system.

      Methodology/Approach: Standardized order sets were developed from best-practice literature/guidelines and follow Quality Based Procedures (QBPs) and Quality Standards where applicable. Approval was obtained from a multidisciplinary team of physicians, clinical educators, pharmacists, and nurses to ensure applicability. All order sets were approved at an organized Order Set Committee. The Mental Health Program was identified as an early adopter group to implement the use of the order set technology platform on their units. Forty-six physician pre- and post-implementation surveys were completed to identify demographics and any barriers related to technology uptake. Parameters such as user demographics, attitudes towards harmonized orders and towards electronic entry were assessed. Technology uptake and application usage data were also analyzed. Findings were used to identify barriers and enablers in adopting standardized electronic order entry.

      Finding/Results: Gender, awareness of QBPs, and computer proficiency impacted the uptake of standardized electronic order entry, while a physicianÂ’s duration within their current position had little effect. Clinicians recognized that harmonized orders improved decision-making whereas their attitudes regarding harmonized orders improving patient safety were unclear. EntryPoint uptake and patient safety incidents may be monitored long term.

      Conclusion/Implications/Recommendations: Findings offered insight into perspectives around change management and standardized electronic order entry. A robust change management plan has been developed to promote clinician utilization of only order entry thought user-acceptance testing, hands-on demonstration, in-time training, and peer-to-peer education. Process mapping sessions are being completed to embed newly acquired hardware into clinician practice. Attitudes from physicians in different programs will be aggregated over the next seven months as the system becomes available throughout THP.

      140 Character Summary: Physician usage of standardized electronic-orders and attitudes towards their implementation was analyzed to promote uptake across multiple sites.

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