Understanding hospital readiness for computerized physician order entry.
BACKGROUND
Many hospitals in the United States are in early stages of decision making and planning to implement computerized physician order entry (CPOE) to improve patient safety and quality of care. The targeted processes and the software for CPOE are complex, and implementation is a large-scale change effort for most hospitals. Hospitals can increase the likelihood of success by understanding and addressing gaps in CPOE readiness. ASSESSING CPOE READINESS: A CPOE readiness assessment tool was developed that includes several different components: external environment; organizational leadership, structure, and culture; care standardization;, order management; access to information; information technology composition; and infrastructure. The presence or absence of these indicators in a particular hospital was determined by on-site interviews, walkarounds with direct observations, and document review.


RESULTS
Assessment results for the first 17 hospitals (bed size, 75-906 beds) indicated that the lowest average component score was in care standardization, while the highest average component score was in organizational structure and function. Organizational culture and the order management process also had low average scores.


CONCLUSIONS
This CPOE readiness assessment revealed significant gaps in all the hospitals examined. Identifying these gaps and addressing them before CPOE implementation can reduce risks. Organizations need to develop expertise at accomplishing and sustaining change; understanding and building CPOE readiness is an important first step.
Stablein
Dona
D
First Consulting Group, Salt Lake City, UT, USA. dstablein@fcg.com
Welebob
Emily
E
Johnson
Elizabeth
E
Metzger
Jane
J
Burgess
Robert
R
Classen
David C
DC
D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003659:Decision Making, Organizational; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D004059:Diffusion of Innovation; D006739:Hospital Administration / Q000145:classification* / Q000592:standards; D006751:Hospital Information Systems / Q000458:organization & administration; D006801:Humans; D019451:Information Management; D007857:Leadership; D008505:Medical Staff, Hospital / Q000523:psychology*; D015279:Organizational Culture; D009937:Organizational Objectives; D012984:Software; D017749:Total Quality Management / Q000458:organization & administration; D014481:United States