Applied clinical informatics
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Multicenter Study
Impact of Electronic Physician Order-Set on Antibiotic Ordering Time in Septic Patients in the Emergency Department.
Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality. ⋯ Utilization of the order-set was associated with a potentially clinically significant, but not statistically significant, reduced time to antibiotic ordering in patients with sepsis. Electronic order-sets are a promising tool to assist hospitals with meeting the Centers for Medicare and Medicaid Services core measure.
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Clinician progress notes are an important record for care and communication, but there is a perception that electronic notes take too long to write and may not accurately reflect the patient encounter, threatening quality of care. Automatic speech recognition (ASR) has the potential to improve clinical documentation process; however, ASR inaccuracy and editing time are barriers to wider use. We hypothesized that automatic text processing technologies could decrease editing time and improve note quality. To inform the development of these technologies, we studied how physicians create clinical notes using ASR and analyzed note content that is revised or added during asynchronous editing. ⋯ Process interventions to reduce ASR documentation burden, whether related to technology or the dictation/editing workflow, should apply a portfolio of solutions to address all categories of required edits. Improved processes could reduce an important barrier to broader use of ASR by clinicians and improve note quality.