Computerized Physician Order Entry (CPOE) systems have been implemented in many hospitals and more are being implemented each day. The benefits of these systems are supposed to be increased patient safety, decreased work for nurses and physicians, decreases in delays in care and improved patient outcomes. However, unintended consequences have been realized as well. These unintended consequences need to be recognized and managed.
Ash, Sittig, Poon, Guappone, Campell and Dyskstra have identified nine types of unintended consequences, they are: more/new work issues, workflow issues, never ending demands, paper persistence, communications issues, emotions, new kinds of errors, changes in power structures, and overdependence on technology. The …show more content…
Problems cited were the computer makes you complete all steps in a task in order to complete a task, even if those steps are not necessary to accomplish the actual work done (Ash, et al., 2007). More complex cases required even more steps to complete tasks, again even if the tasks themselves were not seen as complex (Ash, et al., 2007). Workflow was also impacted for providers seemingly negatively. While workflows for nurses were improved and seen to be more efficient, providers felt that they were taking on tasks that others used to perform creating new work for them and making their workflow less efficient as a result (Ash, et al., 2007). Having providers do work that used to be performed by others was seen as a problem by providers, and as taking away from patient care time (Ash, et al., 2007). Never ending system demands were stated to be unending maintenance, equipment upgrades and need for more data were time consuming and costly (Ash, et al., 2007). Loss of face-to-face communication was cited as a concern as more and more dependence on system alerts become the norm (Ash, et. al., 2007). Special focus to educating staff on the importance of face to face communication was initiated in some of the reporting hospitals as well as alert fatigue training to be sure staff does not ignore alerts that due show on computerized systems (Ash, et al., 2007). Over reliance on the technology was cited as a concern due to errors going unnoticed, alerts and alarms being so prolific that staff become desensitized to responding to them and the inability to operate during system downtime (Ash, et al., 2007). Finally, the strong emotions associated with implementation were underestimated and impacted staff functioning (Ash, et al., 2007). The emotions were noted to get more even as time passed, and leveled out once adaptation to the new processes were achieved (Ash, et al.,
Ash, Sittig, Poon, Guappone, Campell and Dyskstra have identified nine types of unintended consequences, they are: more/new work issues, workflow issues, never ending demands, paper persistence, communications issues, emotions, new kinds of errors, changes in power structures, and overdependence on technology. The …show more content…
Problems cited were the computer makes you complete all steps in a task in order to complete a task, even if those steps are not necessary to accomplish the actual work done (Ash, et al., 2007). More complex cases required even more steps to complete tasks, again even if the tasks themselves were not seen as complex (Ash, et al., 2007). Workflow was also impacted for providers seemingly negatively. While workflows for nurses were improved and seen to be more efficient, providers felt that they were taking on tasks that others used to perform creating new work for them and making their workflow less efficient as a result (Ash, et al., 2007). Having providers do work that used to be performed by others was seen as a problem by providers, and as taking away from patient care time (Ash, et al., 2007). Never ending system demands were stated to be unending maintenance, equipment upgrades and need for more data were time consuming and costly (Ash, et al., 2007). Loss of face-to-face communication was cited as a concern as more and more dependence on system alerts become the norm (Ash, et. al., 2007). Special focus to educating staff on the importance of face to face communication was initiated in some of the reporting hospitals as well as alert fatigue training to be sure staff does not ignore alerts that due show on computerized systems (Ash, et al., 2007). Over reliance on the technology was cited as a concern due to errors going unnoticed, alerts and alarms being so prolific that staff become desensitized to responding to them and the inability to operate during system downtime (Ash, et al., 2007). Finally, the strong emotions associated with implementation were underestimated and impacted staff functioning (Ash, et al., 2007). The emotions were noted to get more even as time passed, and leveled out once adaptation to the new processes were achieved (Ash, et al.,