Research and Projects: AHRQ THQIT and SRD Portfolio

Wisconsin

CPOE Implementation in ICUs

Description:  Assesses the implementation of CPOE systems in 6 intensive care units (ICUs) and evaluates the value and outcomes of patient safety involving medication errors; quality of care; end users' job tasks, perceptions, and attitudes; and financial impact.

Abstract:  DESCRIPTION: (PROVIDED BY APPLICANT): Healthcare technologies can be used to decrease medication errors throughout the medication process. However, the implementation of technology has not always been without troubles. This application builds on an existing interdisciplinary research network, and proposes to examine the value of CPOE technology in various domains (patient safety, quality of care, and end users) and at various levels (unit, patient, end user) in 6 intensive care units of an academic hospital, the University of Wisconsin Hospital and Clinics (UWHC). The application also aims at using prospective human factors analysis methods for improving the design and implementation of CPOE, and at examining the impact of CPOE on end users. The human factors engineering approach to CPOE implementation in ICUs is unique, and, because of its theoretical basis, can provide important information on concepts and methods for improving the design and usage of CPOE in healthcare institutions. A pre-post design will be used to examine the impact of CPOE implementation in 6 ICUs at the UWHC: (1) Trauma Life Support Center, (2) neuro-surgery ICU, (3) cardio-thoracic surgery ICU, (4) cardiac ICU, (5) burn unit, and (6) pediatric ICU. We propose to evaluate value and outcomes in the following domains: (1) patient safety-medication errors (evaluation of ADEs), (2) quality of care (length of stay, mortality, complications and use of prophylaxis), (3) end users' job tasks and perceptions and attitudes (questionnaire survey and observations of job tasks), and (4) financial impact (data derived from the hospital accounting system). The information learned will advance the scientific knowledge in patient safety in two ways: (1) there will be a better understanding of medication errors and the impact of CPOE technology on number and severity of these errors in ICUs, and (2) the human factors approach to technology implementation in health care and the effects on the end users will be shared concerning a new technology that is likely to be widely adopted in the next few years, namely CPOE technology.

Year 1 Funding:  $471,884

Estimated Total Funding:  $1,455,066

Principal Investigator:  Pascale Carayon

Applicant Institution:  University of Wisconsin

City/Town:  Madison, Wisconsin

State:  Wisconsin

Grant Number:  R01 HS15274

Category:  Value Grants (THQIT)

Thesaurus Terms:  automated medical record system, computer assisted patient care, computer system design /evaluation, health care quality, health care service evaluation, intensive care, patient safety /medical error, computer assisted medical decision making, computer human interaction, computer program /software, health care cost /financing, clinical research, health services research tag, human subject, questionnaire

Project Start Date:  Sep 1, 2004

Project End Date:  Aug 31, 2007