title: From clinical pathways to CPOE: challenges and opportunities in standardization and computerization of postoperative orders for total joint replacement.
abstract: Clinical pathways, or caremaps, have become key tools for hospitals to streamline patient care. They are most applicable in situations where a high degree of predictability regarding treatment and/or diagnostic intervention is expected. Perceived advantages include cost savings, more uniform nursing care, and improved patient satisfaction. Total joint replacement is an ideal indication for implementation of clinical pathways. At the authors' institution, despite the adoption of a clinical pathway for these procedures, postoperative orders continue to be handwritten DE NOVO adding variability that may be detrimental to patient safety. This article describes the authoring and implementation of a computerized order process for the care of postoperative total joints patients using a multidisciplinary approach.
authors.affiliation: Division of Orthopaedic Surgery, Box 3000, Orange Zone, Duke South Hospital, Trent Drive, Durham, NC 27710, USA. vikor001@mc.duke.edu
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Vikoren
authors.forename: R Clayton
authors.initials: RC
authors.lastname: Musser
authors.forename: James E
authors.initials: JE
authors.lastname: Tcheng
authors.forename: James A
authors.initials: JA
authors.lastname: Nunley
mesh_terms: D019643:Arthroplasty, Replacement / Q000592:standards*; D019091:Critical Pathways; D006801:Humans; D050316:Medical Order Entry Systems / Q000458:organization & administration*; D009741:Nursing Staff, Hospital; D019637:Orthopedic Procedures / Q000592:standards*; D011182:Postoperative Care / Q000592:standards*; D016730:Program Development