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了解在实施计算机化医师医嘱录入(CPOE)过程中,医生对工作需求和流程效益的认知是如何演变的。

Understanding how physician perceptions of job demand and process benefits evolve during CPOE implementation.

作者信息

Rai Arun, Keil Mark, Choi Hyoungyong, Mindel Vitali

机构信息

Georgia State University, Atlanta, Georgia, United States.

Hankuk University of Foreign Studies, Dongdaemun-gu, Seoul, Korea.

出版信息

Health Syst (Basingstoke). 2022 Aug 29;12(1):98-122. doi: 10.1080/20476965.2022.2113343. eCollection 2023.

Abstract

We examine how physicians' perceptions of two computerized provider order entry (CPOE) capabilities, standardisation of care protocols and documentation quality, are associated with their perceptions of turnaround time, medical error, and job demand at three phases of CPOE implementation: pre-go-live, initial use, and continued use. Through a longitudinal study at a large urban hospital, we find standardisation of care protocols is positively associated with turnaround time reduction in all phases but positively associated with job demand increase only in the initial use phase. Standardisation also has a positive association with medical error reduction in the initial use phase, but later this effect becomes fully mediated through turnaround time reduction in the continued use phase. Documentation quality has a positive association with medical error reduction in the initial use phase and this association strengthens in the continued use phase. Our findings provide insights to effectively manage physicians' response to CPOE implementation.

摘要

我们研究了医生对两种计算机化医嘱录入(CPOE)功能——护理协议标准化和文档质量——的认知,与他们在CPOE实施的三个阶段(上线前、初始使用和持续使用)对周转时间、医疗差错和工作需求的认知之间的关联。通过对一家大型城市医院的纵向研究,我们发现护理协议标准化在所有阶段都与周转时间的减少呈正相关,但仅在初始使用阶段与工作需求的增加呈正相关。标准化在初始使用阶段也与医疗差错的减少呈正相关,但在持续使用阶段,这种效果后来通过周转时间的减少而完全得到调节。文档质量在初始使用阶段与医疗差错的减少呈正相关,且这种关联在持续使用阶段会增强。我们的研究结果为有效管理医生对CPOE实施的反应提供了见解。

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