Inpatient computer-based standing orders vs physician reminders to increase influenza and pneumococcal vaccination rates: a randomized trial

• HIT Description: Computerized reminder systems and computerized standing orders within a computerized provider order entry system More info...
  
• Purpose of Study: Evaluate the effect of computerized standing nurse orders for influenza and pneumococcal vaccines as compared to physician computerized reminders
  
• Years of study: 1998-1999
  
• Study Design: RCT
  
• Outcomes: impact on health care effectiveness and quality
  

• Settings: University hospital in Indianapolis, including all patients discharged from general medicine wards during the study periods who were eligible for the vaccines
• Intervention: Physicians teams were randomized to standing order versus reminder teams. At discharge, patients care for by physicians on the standing order teams had automatic generation of vaccine orders. Physicians on the reminder teams received computerized reminders regarding the vaccines throughout the patients hospitalization and were prompted to order the vaccines. Reminders were displayed as a pop-up message whenever physicians began a daily order-entry session for the first 5 days of admission and then at discharge.
• Evaluation Method: Vaccine administration was determined by questionnaires to nurses (i.e. was the vaccination given) for patients with vaccine orders
• HIT System Sustainability: Program continues at study institution for all inpatient wards other than intensive care wards
• Quality of Care and Patient Safety Outcome: Standing orders resulted in graeter rates of vaccination compared to physician reminders. 42% of eligible patients treated by physicians on the standing order team received an influenza vaccine compared to 30% on the reminder team; 51% of eligible patients on the standing order team received pneumococcal vaccination compared to 31% on the reminder team.