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

Abstract

AbstractOriginal Article Improvement of the Trauma Care Process by Implementation of a Computerized Physician Order Entry-Based Trauma Team Approach1Purpose: The need for the rapid evaluation and treatment of emergency depart-ment patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to in-formation 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 emergen-cy 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 board-ing 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 pa-tients. Total boarding time was reduced significantly after implementation [medi-an, 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 success-fully implemented and can reduce ED time delays in managing trauma patients. Key wordsEmergency department, Computerized physician order entry, Trauma