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Using lean methodology to improve efficiency of electronic order set maintenance in the hospital
Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement inte...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
British Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067713/ https://www.ncbi.nlm.nih.gov/pubmed/27822373 http://dx.doi.org/10.1136/bmjquality.u211725.w4724 |
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author | Idemoto, Lori Williams, Barbara Blackmore, Craig |
author_facet | Idemoto, Lori Williams, Barbara Blackmore, Craig |
author_sort | Idemoto, Lori |
collection | PubMed |
description | Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement intervention applying lean methodology to create a systematic process for order set review and maintenance. Root cause analysis revealed challenges with unclear prioritization of requests, lack of coordination between teams, and lack of communication between producers and requestors of order sets. In March of 2014, we implemented a systematic, cyclical order set review process, with a set schedule, defined responsibilities for various stakeholders, formal meetings and communication between stakeholders, and transparency of the process. We first identified and deactivated 89 order sets which were infrequently used. Between March and August 2014, 142 order sets went through the new review process. Processing time for the build duration of order sets decreased from a mean of 79.6 to 43.2 days (p<.001, CI=22.1, 50.7). Applying Lean production principles to the order set review process resulted in significant improvement in processing time and increased quality of orders. As use of order sets and other forms of clinical decision support increase, regular evidence and process updates become more critical. |
format | Online Article Text |
id | pubmed-5067713 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | British Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-50677132016-11-07 Using lean methodology to improve efficiency of electronic order set maintenance in the hospital Idemoto, Lori Williams, Barbara Blackmore, Craig BMJ Qual Improv Rep BMJ Quality Improvement Programme Order sets, a series of orders focused around a diagnosis, condition, or treatment, can reinforce best practice, help eliminate outdated practice, and provide clinical guidance. However, order sets require regular updates as evidence and care processes change. We undertook a quality improvement intervention applying lean methodology to create a systematic process for order set review and maintenance. Root cause analysis revealed challenges with unclear prioritization of requests, lack of coordination between teams, and lack of communication between producers and requestors of order sets. In March of 2014, we implemented a systematic, cyclical order set review process, with a set schedule, defined responsibilities for various stakeholders, formal meetings and communication between stakeholders, and transparency of the process. We first identified and deactivated 89 order sets which were infrequently used. Between March and August 2014, 142 order sets went through the new review process. Processing time for the build duration of order sets decreased from a mean of 79.6 to 43.2 days (p<.001, CI=22.1, 50.7). Applying Lean production principles to the order set review process resulted in significant improvement in processing time and increased quality of orders. As use of order sets and other forms of clinical decision support increase, regular evidence and process updates become more critical. British Publishing Group 2016-06-06 /pmc/articles/PMC5067713/ /pubmed/27822373 http://dx.doi.org/10.1136/bmjquality.u211725.w4724 Text en © 2016, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/http://creativecommons.org/licenses/by-nc/2.0/legalcode |
spellingShingle | BMJ Quality Improvement Programme Idemoto, Lori Williams, Barbara Blackmore, Craig Using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
title | Using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
title_full | Using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
title_fullStr | Using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
title_full_unstemmed | Using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
title_short | Using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
title_sort | using lean methodology to improve efficiency of electronic order set maintenance in the hospital |
topic | BMJ Quality Improvement Programme |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067713/ https://www.ncbi.nlm.nih.gov/pubmed/27822373 http://dx.doi.org/10.1136/bmjquality.u211725.w4724 |
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