Starmer John, Lorenzi Nancy, Pinson C Wright
Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA.
AMIA Annu Symp Proc. 2006;2006:749-53.
CPOE systems hold the promise of both reducing medical errors and improving compliance with evidence-based guidelines. Evidence-based order sets have been used to make evidence-based guidelines actionable at the point of care. Investigators have conducted research into factors effecting order set use, but little has been documented regarding order set compliance. Under the direction of the Chief Medical Officer, Vanderbilt University Medical Center undertook a major effort to ensure order sets in the Vanderbilt CPOE system are evidence-based. The Vanderbilt EvidenceWeb was developed in order to monitor use and progress, and to provide feedback to clinical teams based on their requests for data. Monitoring tools and feedback to clinical groups regarding order set use and compliance have proved to be key components in improving delivery of evidence-based care.
计算机化医嘱录入(CPOE)系统有望减少医疗差错并提高对循证指南的依从性。循证医嘱集已被用于使循证指南在医疗点可操作。研究人员对影响医嘱集使用的因素进行了研究,但关于医嘱集依从性的记录却很少。在首席医疗官的指导下,范德堡大学医学中心做出了重大努力,以确保范德堡CPOE系统中的医嘱集以证据为基础。开发了范德堡证据网络(Vanderbilt EvidenceWeb)以监测使用情况和进展,并根据临床团队的数据请求向其提供反馈。事实证明,关于医嘱集使用和依从性的监测工具以及向临床团队提供的反馈是改善循证医疗服务的关键组成部分。