Published online November 1, 2005
PEDIATRICS Vol. 116 No. 5 November 2005, pp. e634-e642 (doi:10.1542/10.1542/peds.2004-0066)
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ELECTRONIC ARTICLE

The Introduction of Computerized Physician Order Entry and Change Management in a Tertiary Pediatric Hospital

Jeffrey S. Upperman, MD*, Patricia Staley, BA*, Kerri Friend, BA*, Jocelyn Benes, RN{ddagger}, Jacque Dailey, RN{ddagger}, William Neches, MD§ and Eugene S. Wiener, MD*

* Surgery
{ddagger} Quality and Care Management
§ Cardiology, Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania

Objectives. The objectives of this review were to document the introduction of computerized physician order entry (CPOE)-centered changes in an academic tertiary care center and to review the CPOE-focused literature.

Design. We performed a systematic literature review of CPOE-related articles indexed on Medline, with particular emphasis on pediatric applications. We focused our commentary around the concepts involved in the implementation process at a tertiary pediatric hospital.

Results. In 2001, the Children’s Hospital of Pittsburgh (CHP) embarked on the process of CPOE design and implementation. We determined that CPOE is a tool for improving pediatric care. The CPOE implementation process is more than a technologic change; it involves an organizational cultural transformation. Although the complete transition to CPOE was little more than 1 year ago, CHP has overcome the typical obstacles of CPOE implementation to begin to realize its many benefits. The early success of CHP was achieved by creating a realistic, positive, work environment, which fostered hospital-wide participation and integration.

Conclusion. CPOE is an invaluable resource for supporting patient safety in health care settings. The successful implementation of CPOE requires a paradigm shift in hospital policies and processes.

Key Words: computerized physician order entry • patient safety • medical errors • adverse events

Abbreviations: CHP, Children’s Hospital of Pittsburgh • ADE, adverse drug event • IOM, Institute of Medicine • CPOE, computerized physician order entry

Accepted May 25, 2005.


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Do your CPOE software include a program for neonatal Total parenteral Nutrition?
Dennis Costakos
Pediatrics Online, 1 Feb 2006 [Full text]