Your assignment is to prepare and submit a paper on idea paper pre-thesis proposal.

Your assignment is to prepare and submit a paper on idea paper pre-thesis proposal. User Satisfaction and Its Implications to CPOE Implementation: The Case of Two Community Hospitals in Westchester, New York The race for full implementation of Computerized Physician Order Entry (CPOE) system is underway, but health care organizations are still at a loss on how they can meet meaningful use requirements when their own employees are resisting the change. There are many reasons cited for such resistance. A study published by the Journal of the American Medical Association (Koppel et al., 2005) highlighted that CPOEs actually facilitated as many as 22 types of medical errors instead of enhancing patient safety in its area of research. Other issues concerning CPOE use have also surfaced in various studies. For example, in a study conducted by April Saathoff, she mentioned that some physicians find the system too difficult to use, while others find it demeaning to enter orders in the system, a job typically allotted to ancillary staff (Saathoff, 2010, p.72).

Recent research highlights the benefits that CPOE offers and reiterates that health care organizations must utilize information systems in order to ensure sustainability and continued development. There is a recent consensus on the capability of CPOE to reduce common order errors, but many professionals say that it is not the cure-all solution to all the ills of the health care system. To ensure the success of CPOE implementation, three things must be done: “(a) [ensure] culture change that allows for risk-free reporting of errors by employees, (b) the use of technology and CPOE systems, and (c) smaller incremental changes [which could potentially affect physician efficiency]” (Sengstack & Gugert, 2005, p.39). When creating an implementation plan, administrators must consider not only the technical requirements of implementation, but also a factor in physician acceptance of the system. If concerned health care personnel do not use the system, then there is no use to implement it. It is important for administrators to create a plan assuring cultural change so that health care professionals will gain motivation in learning the CPOE system and utilizing its features to ensure improved service delivery.

The purpose of this study is to understand how the hospitals managed change and ensured that physicians will participate in the use of the CPOE system. Through this study, other health care organizations can gain insights on how they can deal with physician resistance as well as gather insights on the best practices in change management. Its main research question is “How can health care organizations ensure strong physician participation in CPOE implementation?”

This study deals with the experiences of two community hospitals in Westchester, New York in implementing CPOE systems. It focuses on the various emotions and contentions raised by health care professionals who are directly affected by the new system.

In order to address the questions stated above, this study will outline the implementation plan used by the hospitals, paying particular attention to how the organization ensured positive participation of its employees. It will utilize open-ended, semi-structured interviews to key informants (particularly hospital administrators) to assess possible consequences (both anticipated and unintended consequences) as suggested in a study (Campbell, Sittig, Ash, & Dykstra, 2006). It will also utilize secondary data about the need for a better record keeping system and feedback of hospital personnel concerning CPOE implementation. In the absence of such data, the researcher will conduct a survey using the methodology suggested by Peter Hoonakker, Pascale Carayon and James Walker (2010).

References

Campbell, E. M., Sittig, D. F., Ash, J. S., & Dykstra, K. P. G. R. H. (2006). Types of unintended

consequences related to computerized provider order entry. Journal of American Medical Informatics Association, 13(5), 547–556. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1561794/?tool=pubmed

Hoonakker, P. L. T., Carayon, P., & Walker, J. M. (2010). Measurement of CPOE End-User

Satisfaction Among ICU Physicians and Nurses. Applied Clinical Informatics, 1(3), 268-285. doi:10.4338/ACI-2010-03-RA-0020

Koppel, R., Metlay, J.P., Cohen, A., Abaluck, B., Localio, R., Kimmel, S. E., &Storm, B.L. (2005). Role of Computerized Physician Order Entry Systems in Facilitating Medication Errors. JAMA: The Journal of the American Medical Association, 293(10), 1197-203. doi:10.1001/jama.293.10.1197

Leape, L. L., & Berwick, D. M. (2005). Five Years After To Err Is Human: What have we learned? JAMA:The Journal of the American Medical Association, 293(19), 2384-90. doi:10.1001/jama.293.19.2384

Saathoff, A. (2010). Human Factors Considerations Relevant to CPOE Implementations. Journal

of Healthcare Information Management, 19(3), 71-78. http://www.himss.org/content/files/jhim/19-3/human_factors.pdf

Sengstack, P. P., & Gugert, B. (2005). CPOE Systems: Success Factors and Implementation Issues. Journal of Healthcare Information Management, 18(1), 36-45. http://www.himss.org/content/files/jhim/18-1/focus_success.