The introduction of computerized physician order entry and change management in a tertiary pediatric hospital.
OBJECTIVE
The objectives of this review were to document the introduction of computerized physician order entry (CPOE)-centered changes in an academic tertiary care center and to review the CPOE-focused literature.


METHODS
We performed a systematic literature review of CPOE-related articles indexed on Medline, with particular emphasis on pediatric applications. We focused our commentary around the concepts involved in the implementation process at a tertiary pediatric hospital.


RESULTS
In 2001, the Children's Hospital of Pittsburgh (CHP) embarked on the process of CPOE design and implementation. We determined that CPOE is a tool for improving pediatric care. The CPOE implementation process is more than a technologic change; it involves an organizational cultural transformation. Although the complete transition to CPOE was little more than 1 year ago, CHP has overcome the typical obstacles of CPOE implementation to begin to realize its many benefits. The early success of CHP was achieved by creating a realistic, positive, work environment, which fostered hospital-wide participation and integration.


CONCLUSIONS
CPOE is an invaluable resource for supporting patient safety in health care settings. The successful implementation of CPOE requires a paradigm shift in hospital policies and processes.
Upperman
Jeffrey S
JS
Surgery, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213, USA. jeffrey.upperman@chp.edu
Staley
Patricia
P
Friend
Kerri
K
Benes
Jocelyn
J
Dailey
Jacque
J
Neches
William
W
Wiener
Eugene S
ES
D017598:Efficiency, Organizational; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D009936:Organizational Innovation; D011785:Quality Assurance, Health Care