Pandora's box: physician order entry and nursing work redesign.
The Canadian health care industry is undergoing unprecedented restructuring in response to the quest for quality management and cost reduction. Physician order entry and on-line results viewing within a fully integrated hospital clinical information system is often thought to be essential to maximum quality management, cost control, and clinical decision support. Using Hackman and Oldham's Job Characteristics model (1989) as a grounding for discussion, this author examines the impact of computerized physician order entry and on-line results viewing on the intrinsic meaning of nursing work and its subsequent redesign. This paper explores the historical meaning of nursing work related to the manual transcription of physician's orders, and contemplates the implications for future nursing work and research. Until now there has been little discussion in the current informatics literature on this topic.
Richards
J
J
Department of Nursing Informatics, Mount Sinai Hospital, Toronto.
D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D002170:Canada; D005544:Forecasting; D018166:Health Care Reform / Q000458:organization & administration; D006751:Hospital Information Systems; D006801:Humans; D007587:Job Description; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D016294:Models, Nursing; D009313:National Health Programs / Q000458:organization & administration; D020380:Needs Assessment; D024802:Nurse's Role; D015401:Nursing Administration Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology; D009936:Organizational Innovation; D011361:Professional Competence / Q000592:standards; D013673:Technology Assessment, Biomedical; D013996:Time and Motion Studies; D016526:Workload