Improvement of the Trauma Care Process by Implementation of a Computerized Physician Order Entry-Based Trauma Team Approach

Lee, Ji-hwan; Lee, Jin-hee; You, Je-sung; Chung, Sung-phil; Kim, Hyun-jong; Cho, Jun-ho; Kim, Min-joung; Chung, Hyun-soo

doi:2015.21.2.12

Qual Improv Health Care > Volume 21(2); 2015 > Article

Quality Improvement in Health Care 2015;21(2): 12.
DOI: https://doi.org/10.14371/QIH.2015.21.2.12 Published online December 30, 2015.

Improvement of the Trauma Care Process by Implementation of a Computerized Physician Order Entry-Based Trauma Team Approach

Ji-hwan Lee¹, Jin-hee Lee², Je-sung You¹, Sung-phil Chung¹, Hyun-jong Kim³, Jun-ho Cho⁴, Min-joung Kim¹, Hyun-soo Chung¹

¹Department of Emergency Medicine, Yonsei University College of Medicine
²Department of Emergency Medicine, Seoul National University Hospital
³Department of Emergency Medicine, Inje University Ilsan Paik Hospital
⁴Department of Emergency Medicine, Inje University Haeundae Paik Hospital

Abstract

Purpose
The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program.
Methods
This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time.
Results
Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant.
Conclusion
This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

Key words Emergency department;Computerized physician order entry;Trauma;