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使用开放式、半结构化调查工具评估三家社区医院基于计算机的医嘱录入系统的预期后果。

Assessing the anticipated consequences of Computer-based Provider Order Entry at three community hospitals using an open-ended, semi-structured survey instrument.

作者信息

Sittig Dean F, Ash Joan S, Guappone Ken P, Campbell Emily M, Dykstra Richard H

机构信息

Medical Informatics Department, Northwest Permanente, Portland, OR 97227, USA.

出版信息

Int J Med Inform. 2008 Jul;77(7):440-7. doi: 10.1016/j.ijmedinf.2007.08.005. Epub 2007 Oct 10.

Abstract

OBJECTIVE

To determine what "average" clinicians in organizations that were about to implement Computer-based Provider Order Entry (CPOE) were expecting to occur, we conducted an open-ended, semi-structured survey at three community hospitals.

METHODS

We created an open-ended, semi-structured, interview survey template that we customized for each organization. This interview-based survey was designed to be administered orally to clinicians and take approximately 5 min to complete, although clinicians were allowed to discuss as many advantages or disadvantages of the impending system roll-out as they wanted to.

RESULTS

Our survey findings did not reveal any overly negative, critical, problematic, or striking sets of concerns. However, from the standpoint of unintended consequences, we found that clinicians were anticipating only a few of the events, emotions, and process changes that are likely to result from CPOE.

CONCLUSIONS

The results of such an open-ended survey may prove useful in helping CPOE leaders to understand user perceptions and predictions about CPOE, because it can expose issues about which more communication, or discussion, is needed. Using the survey, implementation strategies and management techniques outlined in this paper, any chief information officer (CIO) or chief medical information officer (CMIO) should be able to adequately assess their organization's CPOE readiness, make the necessary mid-course corrections, and be prepared to deal with the currently identified unintended consequences of CPOE should they occur.

摘要

目的

为了确定即将实施基于计算机的医嘱录入系统(CPOE)的机构中“普通”临床医生的预期情况,我们在三家社区医院开展了一项开放式、半结构化调查。

方法

我们创建了一个开放式、半结构化的访谈调查模板,并针对每个机构进行了定制。这项基于访谈的调查旨在以口头方式向临床医生进行,大约需要5分钟完成,不过临床医生可以根据自己的意愿讨论即将推出的系统的诸多优缺点。

结果

我们的调查结果并未揭示出任何过度负面、关键、有问题或引人注目的担忧。然而,从不期望出现的后果角度来看,我们发现临床医生仅预见到了CPOE可能导致的少数事件、情绪和流程变化。

结论

这种开放式调查的结果可能有助于CPOE项目负责人了解用户对CPOE的看法和预测,因为它可以揭示那些需要更多沟通或讨论的问题。利用本文概述的调查、实施策略和管理技巧,任何首席信息官(CIO)或首席医疗信息官(CMIO)都应该能够充分评估其机构对CPOE的准备情况,做出必要的中途调整,并准备好应对CPOE目前已确定的不期望出现的后果(如果发生的话)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/431b/2668516/b5eec16a428d/nihms-54353-f0001.jpg

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