Assessment of improvement in the STAT medication ordering process in a cancer hospital: A pre-post study

Objective To evaluate the effect of a computerized physician order entry (CPOE)-based intervention (a new ‘ONCE’ ordering frequency combined with a system-generated confirmation pop-up) on STAT order burden and on delayed STAT orders in a tertiary cancer hospital. Methods A Pre-Post study design conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan, utilizing the Hospital Information System (HIS) for the analysis of STAT medication orders, as a quality improvement project. A pop-up prompt, generated by the system, was incorporated into the STAT medication ordering process. The primary goal of this integration was to decrease the number of STAT orders and the associated delays. Results The intervention was associated with a 51.5% decrease in STAT order volume (33,334 to 16,162 orders), with the overall STAT burden falling from 25.4% to 12.2% of all medication orders (p < 0.001). Delayed STAT orders declined by 55.4% (15,033 to 6711), from 11.5% to 5.1% of all orders. The two areas with the highest baseline burden showed marked declines: the Preoperative Holding Bay from 52.1% to 29.6% and the Intensive Care Unit from 43.6% to 24.5%. By the final study month, STAT orders comprised 7.8% of all orders, with delayed STAT orders comprising 3.3%. Conclusion The implementation of a new frequency of ONCE and system-generated pop-ups has proven to be an effective method for reducing both the volume and delays of STAT orders.