@article{12917,
  author = {George Kim and Allen R. Chen and Robert J. Arceci and Sandra H. Mitchell and Michelle Kokoszka and Denise Daniel and Christoph U. Lehmann},
  title = {Error reduction in pediatric chemotherapy: computerized order entry and failure modes and effects analysis.},
  abstract = {<p><b>OBJECTIVE: </b>To implement and evaluate the impact of computerized provider order entry (CPOE) on reducing ordering errors in pediatric chemotherapy.</p><p><b>DESIGN: </b>Before-and-after study from 2001 to 2004.</p><p><b>SETTING: </b>Pediatric Oncology in an academic medical center.</p><p><b>INTERVENTION: </b>Implementation of a CPOE system guided by multidisciplinary failure modes and effects analysis into pediatric chemotherapy.</p><p><b>MAIN OUTCOME MEASURES: </b>Completion data on chemotherapy steps of high morbidity/mortality potential if missed (as determined by attending oncologists) from 1259 pre-CPOE paper and 1116 post-CPOE pediatric chemotherapy orders.</p><p><b>RESULTS: </b>After CPOE deployment, daily chemotherapy orders were less likely to have improper dosing (relative risk [RR], 0.26; 95% confidence interval [CI], 0.11-0.61), incorrect dosing calculations (RR, 0.09; 95% CI, 0.03-0.34), missing cumulative dose calculations (RR, 0.32; 95% CI, 0.14-0.77), and incomplete nursing checklists (RR, 0.51; 95% CI, 0.33-0.80). There was no difference in the likelihood of improper dosing on treatment plans and a higher likelihood of not matching medication orders to treatment plans (RR, 5.4; 95% CI, 3.1-9.5).</p><p><b>CONCLUSION: </b>Failure modes and effects analysis-guided CPOE reduced ordering errors in pediatric chemotherapy and provided data for further improvements.</p>},
  year = {2006},
  journal = {Arch Pediatr Adolesc Med},
  volume = {160},
  pages = {495-8},
  month = {05/2006},
  issn = {1072-4710},
  language = {eng},
}