...R I Mount Auburn Hospital: Physician Order Entry Introduction In September of 2002, Robert Todd, the head of information systems (IS) for Mount Auburn Hospital in Cambridge, Massachusetts, reviewed progress toward the launch of the hospital’s new computerized physician order entry (POE) system. The committee overseeing the project consisted of an across-the-board selection of hospital representation, including physicians, pharmacy staff, nurses, administrators, and IS operations staff. The POE system was scheduled to ‚go live‛ on a pilot basis in the middle of October in the hospital’s labor and delivery unit. It had not been difficult to mount support for the project. POE systems had been demonstrated to reduce error rates, and medical errors were widely recognized as a large and serious problem in health care. A landmark study published in 19911 estimated that 1.3 million injuries occurred annually in U.S. hospitals, 69% of which were at last partially due to errors in patient management. The study found that 13% of injuries resulted in patient death, ‚a rate that if extrapolated to the United States as a whole suggested that approximately 180,000 deaths a year were, at least partly, the result of injuries received during the course of care.‛2 This study also found that adverse drug events (ADEs) accounted for nearly 20% of total injuries (making them the largest injury category) and that 45% of ADEs were the result of errors. A later study at two Boston hospitals found...
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...1. Introduction According to Webster’s dictionary (2011) a hospital is a health facility where patients receive treatment. Obviously, this definition does not state anything about the kind of treatment, the right or wrong treatment or who does the treatment a doctor, nurse etc. Questions one may not ask oneself till patients receive a wrong treatment. According to a landmark study in 1991 1.3 million injuries occur annually in U.S. hospitals of which 69% are partially due to errors in patient management and 13% of these resulted in a patient’s death (Mcafee, Macgregor, Benari, 2003.) Also the Mount Auburn Hospital in Cambridge, Massachusetts became aware of the landmark study (1991) and is therefore preparing to set up a physician order entry (POE) system throughout their hospital. The labor and delivery ward will first use the POE system. The new POE system will be able to replace paper-based and verbal medication ordering processes with an information system. A doctor will enter the patient’s medication order via the new system, which will next transfer that order to the internal pharmacy. Mount Auburn faces the challenge of how to introduce the new system successfully to its new users. In addition, medical error rates at the Mount Auburn Hospital can be decreased through the implementation of a POE system, because it will improve the communication of the drug order between the physicians, nurses and pharmacist and it can guarantee available drug and patient information. This...
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...Mount Auburn Hospital: Physician Order Entry (POE) Introduction * 1.3 million injuries occurred annually in 1991 * 69% are partially due to errors in patient management * 13% of these resulted in patient’s death Computerised Physician Order Entry Mount Auburn saw computerised POE as a critical patient-safety tool. Current system: Paper based and verbal communication Common errors in current system * Simple miscommunication of the drug order * Messy handwriting, confusion between names etc… * Lack of knowledge about drugs and patients * Rule violations, slips and memory lapses Advantages of POE When a physician places an order, all the relevant information are shown such as 1) Lab test results 2) Medication the patient is currently on 3) Allergic history etc.. * Everything is in real time – info about new drugs in the market, research finding, patient files * Reduced faulty drug identity checking – name mismatch problem solved * rule violations could also be lower – enhanced monitoring * ordering more streamlined * Reduced transcription error – handwriting issue solved All these will bring greater name to the hospital as the error rates will increase -> one of the Leapfrog’s recommendation is “Evidence-based Hospital referral”, hence this will generate positive name for the hospital. CRM could also be improved as the customer will be more satisfied with lesser errors and reduced...
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...Mount Auburn Hospital: Physician Order Entry Physician Order Entry (POE) * An additional module to the PCI by MEDITECH * Intended to reduce preventable ADEs (Adverse Drug Effects) * Pilot implementation to be done in the labor and delivery unit Overview of the Current Process | Overview of the Proposed Process | Objectives and suggested recommendations Training of staff Any implementation of an extensive system such a POE needs to ensure all stakeholders are onboard the new process. This requires them to accept the changes as well as being sufficiently trained to take advantages of POE. To address the first issue, we suggest involving physicians, nurses, pharmacists etc. early on in the designing the system and discussing their key concerns. Once the entire staff feels part of the team implementing the change, they are more likely to accept it than if asked to adopt a predetermined decision. A system adoption statistic can be released monthly to encourage each ward to compete and speedily implement the new change. For training, staff should be fully trained in a seminar about the key aspects of the system that concern them. A systems manager should always be available for troubleshooting. Expansion of system adoption The decision to implement the phase 1 of POE in labour and delivery ward makes sense as the medication and treatments there are much simpler to try out the new system. POE system can be tested here for months and changes suggested can be implemented...
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...NaNotechNology applicatioNs for cleaN Water Micro & NaNo TechNologies series editor: Jeremy ramsden Professor of Nanotechnology Microsystems and Nanotechnology Centre, Department of Materials Cranfield University, United Kingdom the aim of this book series is to disseminate the latest developments in small scale technologies with a particular emphasis on accessible and practical content. these books will appeal to engineers from industry, academia and government sectors. for more information about the book series and new book proposals please contact the publisher, Dr. Nigel hollingworth at nhollingworth@williamandrew.com. http://www.williamandrew.com/MNt NaNotechNology applicatioNs for cleaN Water edited by Nora savage Office of Research and Development, US Environmental Protection Agency and (in alphabetical order) Mamadou Diallo Materials and process simulation center, Division of chemistry and chemical engineering, california institute of technology Jeremiah Duncan Nanoscale Science and Engineering Center, University of Wisconsin-Madison anita street Office of Research and Development, US Environmental Protection Agency and Center of Advanced Materials for the Purification of Water with Systems, University of Illinois at Urbana-Champaign richard sustich N o r w i c h , N Y, U S A copyright © 2009 by William andrew inc. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying...
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...10000 quiz questions and answers www.cartiaz.ro 10000 general knowledge questions and answers 10000 general knowledge questions and answers www.cartiaz.ro No Questions Quiz 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 Carl and the Passions changed band name to what How many rings on the Olympic flag What colour is vermilion a shade of King Zog ruled which country What colour is Spock's blood Where in your body is your patella Where can you find London bridge today What spirit is mixed with ginger beer in a Moscow mule Who was the first man in space What would you do with a Yashmak Who betrayed Jesus to the Romans Which animal lays eggs On television what was Flipper Who's band was The Quarrymen Which was the most successful Grand National horse Who starred as the Six Million Dollar Man In the song Waltzing Matilda - What is a Jumbuck Who was Dan Dare's greatest enemy in the Eagle What is Dick Grayson better known as What was given on the fourth day of Christmas What was Skippy ( on TV ) What does a funambulist do What is the name of Dennis the Menace's dog What are bactrians and dromedaries Who played The Fugitive Who was the King of Swing Who was the first man to fly across the channel Who starred as Rocky Balboa In which war was the charge of the Light Brigade Who invented the television Who would use a mashie niblick In the song who killed Cock Robin What do deciduous...
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...C h a p t e r 1 Prewriting GETTING STARTED (OR SOUP-CAN LABELS CAN BE FASCINATING) For many writers, getting started is the hardest part. You may have noticed that when it is time to begin a writing assignment, you suddenly develop an enormous desire to straighten your books, water your plants, or sharpen your pencils for the fifth time. If this situation sounds familiar, you may find it reassuring to know that many professionals undergo these same strange compulsions before they begin writing. Jean Kerr, author of Please Don’t Eat the Daisies, admits that she often finds herself in the kitchen reading soup-can labels—or anything—in order to prolong the moments before taking pen in hand. John C. Calhoun, vice president under Andrew Jackson, insisted he had to plow his fields before he could write, and Joseph Conrad, author of Lord Jim and other novels, is said to have cried on occasion from the sheer dread of sitting down to compose his stories. To spare you as much hand-wringing as possible, this chapter presents some practical suggestions on how to begin writing your short essay. Although all writers must find the methods that work best for them, you may find some of the following ideas helpful. But no matter how you actually begin putting words on paper, it is absolutely essential to maintain two basic ideas concerning your writing task. Before you write a single sentence, you should always remind yourself that 1. You have some valuable ideas to tell your reader,...
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