title: Computerized Provider Order Entry with Pager Notification Improves Efficiency in STAT Radiographic Studies and Respiratory Treatments.
abstract: BACKGROUND
  The use of computerized provider order entry (CPOE) has been widely linked to improvements in patient safety. We hypothesized that electronic routing of CPOE-generated orders through individual pagers would improve the efficiency of STAT radiographic studies and respiratory treatments.
  
  
  METHODS
  The study was conducted in two periods before and after implementing pager notification of STAT orders. In the Baseline Period, CPOE-generated STAT orders were communicated to radiology technicians or respiratory therapists through the use of printed orders, manual paging and/or telephone communication. The time to process the order and deliver a radiology result or respiratory treatment was tracked. In the Intervention Period CPOE-generated STAT orders were electronically routed to the radiology technician's or respiratory therapist's pager. During both time periods, clinicians completed user satisfaction surveys.
  
  
  RESULTS
  Using pager notification, there was a significant reduction in radiology technician arrival time (16.8±2.1 vs 7.9±0.7 mins, p<0.001). Similarly there was a significant reduction in the cumulative time required to capture the radiographic image, image availability in the picture archiving and communication system (PACS) and the verbal report from the radiologist (p<0.05). The time required in obtaining a preliminary or final radiographic written report and the total cycle times were not significantly reduced. For STAT respiratory therapy orders there was a significant reduction in the mean time from ordering to administration of respiratory therapy treatments (124.7±14.1 vs 49.8±11.4 minutes, p<0.01). Radiologists, respiratory therapists and ordering clinicians reported improved satisfaction after implementation of pager notification.
  
  
  CONCLUSIONS
  Computer-generated orders for STAT radiographic studies and respiratory treatments can be carried out significantly faster through the use of direct pager notification. The implementation of this process has resulted in improved care delivery and widespread clinician satisfaction.
authors.affiliation: Center for Pediatric Informatics, Children's National Medical Center , Washington DC.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Jacobs
authors.forename: Eric
authors.initials: E
authors.lastname: Crotty
authors.forename: Ed
authors.initials: E
authors.lastname: Conway
authors.forename: Kim Ward
authors.initials: KW
authors.lastname: Hart
authors.forename: Craig
authors.initials: C
authors.lastname: Dietrich
authors.forename: Scott
authors.initials: S
authors.lastname: Pettinichi
authors.forename: John
authors.initials: J
authors.lastname: Racadio
keywords: Care orders; Computerized provider order entry; Efficiency; Radiology; Respiratory therapy