Chen CF |
------>authors3_c=??? ------>paper_class1=2 ------>Impact_Factor=None ------>paper_class3=0 ------>paper_class2=0 ------>vol= ------>confirm_bywho=shtsai ------>insert_bywho=wtchiu ------>Jurnal_Rank=None ------>authors4_c= ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=19 ------>paper_class2Letter=None ------>page2= ------>medlineContent= ------>unit=J0600 ------>insert_date=20060404 ------>iam=3 ------>update_date=None ------>author=??? ------>change_event=4 ------>ISSN= ------>authors_c= ------>score=20 ------>journal_name=APACPH, Taiwan ------>paper_name=Integration of practice guideline in physician order entry system. ------>confirm_date=20060414 ------>tch_id=073010 ------>pmid=16357360 ------>page1= ------>fullAbstract=OBJECTIVE: In the context of an inpatient care provider order entry (CPOE) system, to evaluate the impact of a decision support tool on integration of cardiology "best of care" order sets into clinicians~ admission workflow, and on quality measures for the management of acute myocardial infarction (AMI) patients. DESIGN: A before-and-after study of physician orders evaluated (1) per-patient use rates of standardized acute coronary syndrome (ACS) order set and (2) patient-level compliance with two individual recommendations: early aspirin ordering and beta-blocker ordering. MEASUREMENTS: The effectiveness of the intervention was evaluated for (1) all patients with ACS (suspected for AMI at the time of admission) (N = 540) and (2) the subset of the ACS patients with confirmed discharge diagnosis of AMI (n = 180) who comprise the recommended target population who should receive aspirin and/or beta-blockers. Compliance rates for use of the ACS order set, aspirin ordering, and beta-blocker ordering were calculated as the percentages of patients who had each action performed within 24 hours of admission. RESULTS: For all ACS admissions, the decision support tool significantly increased use of the ACS order set (p = 0.009). Use of the ACS order set led, within the first 24 hours of hospitalization, to a significant increase in the number of patients who received aspirin (p = 0.001) and a nonsignificant increase in the number of patients who received beta-blockers (p = 0.07). Results for confirmed AMI cases demonstrated similar increases, but did not reach statistical significance. CONCLUSION: The decision support tool increased optional use of the ACS order set, but room for additional improvement exists. ------>tmu_sno=None ------>sno=13280 ------>authors2=Li YC ------>authors3=Chiu WT ------>authors4= ------>authors5= ------>authors6= ------>authors6_c= ------>authors=Chen CF ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=1 ------>updateTitle=Integrating "best of care" protocols into clinicians~ workflow via care provider order entry: impact on quality-of-care indicators for acute myocardial infarction. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no= ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2005 ------>submit_flag=None ------>publish_month=11 |