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AAP Grand Rounds 15:32-33 (2006)
© 2006 American Academy of Pediatrics

Unexpected Increase in Mortality Associated with Implementation of a Computerized Order Entry System

The first 20% of the full text of this article appears below.

Investigators from Children’s Hospital of Pittsburgh present mortality data on children transported to their facility during an 18-month study period (October 2001–March 2003). The study period included 13 months before implementation of a hospital-wide computerized physician order entry (CPOE) system and 5 months after implementation. Data collected included demographic information, Pediatric Risk of Mortality (PRISM) score,¹ and primary diagnosis categories.

There were 1942 admissions during the study period: 1394 before CPOE use and 548 after CPOE implementation, with 1102 (57%) admitted to an intensive care unit (ICU). Seventy- five children died (3.9%). During the 2 time periods, patients had similar risk of death determined by PRISM scores and similar admission diagnosis categories. The unadjusted mortality before CPOE use was 2.8% compared with 6.6% afterward. Before CPOE, standardized mortality (actual/ predicted) was consistently <1; however, after implementation of CPOE, the ratio for the next . . . [Full Text of this Article]

Susan L. Bratton, MD, MPH, FAAP

Pediatric Critical Care Medicine, Primary Children’s Medical Center, University of Utah Health Sciences Center, Salt Lake City, UT

 

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				S. L. Bratton Computerized Provider Order Entry Redux AAP Grand Rounds, October 1, 2006; 16(4): 42 - 42. [Full Text] [PDF]