Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit.
Approach to Improving Safety
Setting of Care
This study evaluated the effects of implementation of a computerized provider order entry (CPOE) system in a tertiary care pediatric intensive care unit (PICU). An earlier, widely publicized study had found an increase in mortality among PICU patients in another hospital that implemented the same CPOE system. Prior to implementing the CPOE system in this study, leaders from both hospitals collaborated to identify problems with the initial implementation and develop effective implementation strategies. This collaboration yielded several strategies, including using standardized order sets and other means of decreasing the time needed to enter orders, preserving a system of obtaining medications outside the CPOE system in emergencies, and emphasizing the need for face-to-face communication between physicians and nurses. In contrast to the earlier study, the authors found no change in PICU mortality in 13 months after the CPOE system was installed. The authors noted that the lessons learned from the initial implementation problems were essential to ensuring successful implementation at their institution.