Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. 678 (doi:10.1542/peds.2008-0084)
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LETTER TO THE EDITOR

Impact of Computerized Prescriber Order Entry on the Incidence of Adverse Drug Events in Pediatric Inpatients

David S. Dickens, MD
Diane Sinsabaugh, RPh
Pediatric Hematology/Oncology and Bone Marrow Transplantation,
Helen DeVos Children's Hospital,
Grand Rapids, MI 49503

To the Editor.—

Hospital-based computerized order entry systems (CPOEs) are widely touted as a solution for improving patient safety. Holdsworth et al1 conducted the first pediatric study that demonstrated that the benefits of CPOEs extend beyond the prevention of medication errors to a reduction in adverse drug events. Patient safety and CPOE are coexisting priorities for many institutions. The documentation of a process that successfully achieves both goals is sure to attract attention and serve as a model for other institutions. Therefore, such research should not be focused on the achievement of success as much as on how the success was obtained. The authors repeatedly mentioned that "substantial" resources were used and would be required by others interested in duplicating their success. Precise details on resource allocation would be of great benefit to other medical professionals who become institutionally conscripted into CPOE design as a result of such findings.

In addition, we noted that a 3-year period elapsed between CPOE implementation and the start of data collection to allow for "acclimation" to the new process. Data collected during this 3-year acclimation period may have provided valuable information with regards to specific challenges and required process changes.

Finally, although CPOE implementation reduces traditionally defined medication errors, other error types are facilitated.2 One such error type created by CPOE, medication delays, was specifically excluded from analysis.

In summary, we believe that as new processes that improve patient safety are identified, full disclosure of required resources and transitional data will lead to improved implementation at other institutions.

REFERENCES

  1. Holdsworth MT, Fichtl RE, Raisch DW, et al. Impact of computerized prescriber order entry on the incidence of adverse drug events in pediatric inpatients. Pediatrics. 2007;120 (5):1058 –1066[Abstract/Free Full Text]
  2. Koppel R, Metlay JP, Cohen A, et al. Role of computerized physician order entry systems in facilitating medication errors. JAMA. 2005;293 (10):1197 –1203[Abstract/Free Full Text]
PEDIATRICS (ISSN 1098-4275). ©2008 by the American Academy of Pediatrics

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This Article
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