Healthcare technologies can be used to decrease medication errors throughout the medication process. However, the implementation of technology has not always been without troubles. This application builds on an existing interdisciplinary research network, and proposes to examine the value of CPOE technology in various domains (patient safety, quality of care, and end users) and at various levels (unit, patient, end user) in 6 intensive care units of an academic hospital, the University of Wisconsin Hospital and Clinics (UWHC). The application also aims at using prospective human factors analysis methods for improving the design and implementation of CPOE, and at examining the impact of CPOE on end users. The human factors engineering approach to CPOE implementation in ICUs is unique, and, because of its theoretical basis, can provide important information on concepts and methods for improving the design and usage of CPOE in healthcare institutions. A pre-post design will be used to examine the impact of CPOE implementation in 6 ICUs at the UWHC: (1) Trauma Life Support Center, (2) neuro-surgery ICU, (3) cardio-thoracic surgery ICU, (4) cardiac ICU, (5) burn unit, and (6) pediatric ICU. We propose to evaluate value and outcomes in the following domains: (1) patient safety-medication errors (evaluation of ADEs), (2) quality of care (length of stay, mortality, complications and use of prophylaxis), (3) end users' job tasks and perceptions and attitudes (questionnaire survey and observations of job tasks), and (4) financial impact (data derived from the hospital accounting system). The information learned will advance the scientific knowledge in patient safety in two ways: (1) there will be a better understanding of medication errors and the impact of CPOE technology on number and severity of these errors in ICUs, and (2) the human factors approach to technology implementation in health care and the effects on the end users will be shared concerning a new technology that is likely to be widely adopted in the next few years, namely CPOE technology.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
5R01HS015274-02
Application #
6941327
Study Section
Special Emphasis Panel (ZHS1-HSR-H (01))
Program Officer
Grace, Erin
Project Start
2004-09-01
Project End
2007-08-31
Budget Start
2005-09-01
Budget End
2006-08-31
Support Year
2
Fiscal Year
2005
Total Cost
Indirect Cost
Name
University of Wisconsin Madison
Department
Engineering (All Types)
Type
Schools of Engineering
DUNS #
161202122
City
Madison
State
WI
Country
United States
Zip Code
53715
Carayon, Pascale; Wetterneck, Tosha B; Cartmill, Randi et al. (2017) Medication Safety in Two Intensive Care Units of a Community Teaching Hospital After Electronic Health Record Implementation: Sociotechnical and Human Factors Engineering Considerations. J Patient Saf :
Carayon, Pascale; Wetterneck, Tosha B; Alyousef, Bashar et al. (2015) Impact of electronic health record technology on the work and workflow of physicians in the intensive care unit. Int J Med Inform 84:578-94
Carayon, Pascale; Weinger, Matthew B; Brown, Roger et al. (2015) How Do Residents Spend Their Time in the Intensive Care Unit? Am J Med Sci 350:403-8
Carayon, Pascale; Wetterneck, Tosha B; Cartmill, Randi et al. (2014) Characterising the complexity of medication safety using a human factors approach: an observational study in two intensive care units. BMJ Qual Saf 23:56-65
Hoonakker, Peter L T; Carayon, Pascale; Brown, Roger L et al. (2013) Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units. J Am Med Inform Assoc 20:252-9
Hundt, Ann Schoofs; Adams, Jean A; Schmid, J Andrew et al. (2013) Conducting an efficient proactive risk assessment prior to CPOE implementation in an intensive care unit. Int J Med Inform 82:25-38
Hoonakker, Peter L T; Carayon, Pascale; Walker, James M et al. (2013) The effects of Computerized Provider Order Entry implementation on communication in Intensive Care Units. Int J Med Inform 82:e107-17
Cartmill, Randi S; Walker, James M; Blosky, Mary Ann et al. (2012) Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. Int J Med Inform 81:782-91
Hoonakker, Peter; Carayon, Pascale; Gurses, Ayse et al. (2011) MEASURING WORKLOAD OF ICU NURSES WITH A QUESTIONNAIRE SURVEY: THE NASA TASK LOAD INDEX (TLX). IIE Trans Healthc Syst Eng 1:131-143
Carayon, Pascale; Cartmill, Randi; Blosky, Mary Ann et al. (2011) ICU nurses' acceptance of electronic health records. J Am Med Inform Assoc 18:812-9

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