-
In the morning, ID fellows review the night's orders. Sometimes they demand changes. (But changing antibiotic regimes can be problematic, so the ID fellows let most orders stand.)
-
Because ID fellows often take no remedial actions, and housestaff can game the system, stealth dosing weakens antimicrobial oversight.
-
Lesson: Interaction of (A) the social system with (B) the HIT affects (C) HIT-in-use, which then further alters (A) the social system
-
A B C (A = eager housestaff, B = CPOE/EHR, C = how HIT is really used)
