![HITO Victor Lee, Zynx Health]( "HITO Victor Lee, Zynx Health")
I had a recent conversation with some members of a hospital’s quality improvement team, and while they had celebrated the successful implementation of their evidence-based order sets into their computerized provider order entry system more than a year ago, they were now trying to optimize processes for keeping all of their order sets and other CDS content updated. By Victor Lee, MD, Zynx Health
By Victor Lee, MD, Zynx Health
I had a recent conversation with some members of a hospital’s quality improvement team, and while they had celebrated the successful implementation of their evidence-based order sets into their computerized provider order entry system more than a year ago, they were now trying to optimize processes for keeping all of their order sets and other CDS content updated. Some members of their original implementation team had been reassigned to other projects after go-live, and the excitement about evidence-based order set implementation had since dissipated. Nevertheless, the remainder of the team still had to identify and address changes in best practices that could impact clinical and financial outcomes. Does this sound familiar to you?
Why does having a process for updates and maintenance of CDS matter? Some people say that during the initial implementation, they had to shorten order sets to gain physician adoption, and this led to the omission of interventions that are associated with reductions in mortality, readmissions, length of stay, cost, and other outcomes. Others state that keeping pace with national performance measures and guideline recommendations is important to them. Some people I know have said that keeping order sets current is simply the right thing to do. It turns out that the Centers for Medicare and Medicaid Services has also issued guidance on this topic:
“Hospitals may use pre-printed and electronic standing orders, order sets, and protocols for patient orders only if… periodic and regular review of such orders and protocols is conducted by the medical staff and the hospital’s nursing and pharmacy leadership.”
What policies and processes does your healthcare organization have in place for ensuring that your CDS content is regularly updated? What resources do you use to stay current with evolving evidence-based best practices? What is your governance process? How do you get clinical subject matter experts engaged? These are all key considerations to ensuring your CDS content is up to date.
About the Author
Victor Lee, MD, has a background as an internal medicine hospitalist and is VP of clinical informatics at Zynx Health. A self-described geek, he enjoys photography, videography, and making home movies. Ask him who his favorite mixed martial arts fighters are, but only if you are prepared to have him talk incessantly about the sport.
You can view Victor’s original blog post here.
