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The impact of computerized provider order entry on emergency department flow

Overview of attention for article published in CJEM: Canadian Journal of Emergency Medicine, March 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#36 of 970)
  • High Attention Score compared to outputs of the same age (94th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

blogs
1 blog
twitter
44 tweeters
facebook
3 Facebook pages
googleplus
1 Google+ user

Citations

dimensions_citation
2 Dimensions

Readers on

mendeley
22 Mendeley
Title
The impact of computerized provider order entry on emergency department flow
Published in
CJEM: Canadian Journal of Emergency Medicine, March 2016
DOI 10.1017/cem.2016.11
Pubmed ID
Authors

Andrew Gray, Christopher M.B. Fernandes, Kristine Van Aarsen, Melanie Columbus

Abstract

Computerized provider order entry (CPOE) has been established as a method to improve patient safety by avoiding medication errors; however, its effect on emergency department (ED) flow remains undefined. We examined the impact of CPOE implementation on three measures of ED throughput: wait time (WT), length of stay (LOS), and the proportion of patients that left without being seen (LWBS). We conducted a retrospective cohort study of all ED patients of 18 years and older presenting to London Health Sciences Centre during July and August 2013 and 2014, before and after implementation of a CPOE system. The three primary variables were compared between time periods. Subgroup analyses were also conducted within each Canadian Triage and Acuity Scale (CTAS) level (1-5) individually, as well as for admitted patients only. A significant increase in WT of 5 minutes (p=0.036) and LOS of 10 minutes (p=0.001), and an increase in LWBS from 7.2% to 8.1% (p=0.002) was seen after CPOE implementation. Admitted patients' LOS increased by 63 minutes (p<0.001), the WT of CTAS 3 and 5 patients increased by 6 minutes (p=0.001) and 39 minutes (p=0.005), and LWBS proportion increased significantly for CTAS 3-5 patients, from 24.3% to 42.0% (p<0.001) for CTAS 5 patients specifically. CPOE implementation detrimentally impacted all patient flow throughput measures that we examined. The most striking clinically relevant result was the increase in LOS of 63 minutes for admitted patients. This raises the question as to whether the potential detrimental effects to patient safety of CPOE implementation outweigh its benefits.

Twitter Demographics

The data shown below were collected from the profiles of 44 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 11 50%
Unspecified 2 9%
Student > Ph. D. Student 2 9%
Student > Bachelor 2 9%
Librarian 2 9%
Other 3 14%
Readers by discipline Count As %
Nursing and Health Professions 7 32%
Medicine and Dentistry 5 23%
Unspecified 3 14%
Computer Science 2 9%
Pharmacology, Toxicology and Pharmaceutical Science 1 5%
Other 4 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 36. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 March 2019.
All research outputs
#473,107
of 13,528,132 outputs
Outputs from CJEM: Canadian Journal of Emergency Medicine
#36
of 970 outputs
Outputs of similar age
#14,789
of 259,925 outputs
Outputs of similar age from CJEM: Canadian Journal of Emergency Medicine
#1
of 17 outputs
Altmetric has tracked 13,528,132 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 970 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.9. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 259,925 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 17 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.