Implementation of disease-based standard order sets in emergency department of tertiary care hospital, Pakistan- a novel approach for enhancing patient care
Objectives: To evaluate the efficacy of disease-based standard order sets in reducing time of order entry, order processing and medication dispensation in emergency department of a tertiary care hospital.
Methods: The pilot study was conducted as part of a retrospective clinical audit using pre- and post-intervention design comprising data from July to September 2013 of the emergency department of a tertiary care hospital in Karachi. Data collected related to the reduction in medicine order entry, processing and dispensing time of eight common emergency conditions with standard order set. Subsequently, standard medication orders for the selected medical conditions were developed together with physicians of emergency and other specialties. Post-intervention data was collected and the two data sets were compared using SPSS version 23.0.
Results: Mean medication order entry and processing time from the physician end improved from 67.7±22.7 seconds to 20.5±7.1 seconds. Mean order processing and medication processing and dispensing time at pharmacist end reduced from 70.0±22.4 to 20.6±8.8 seconds. The difference between pre- and post-intervention values was significant (p<0.001).
Conclusion: Implementation of disease-based standard order set significantly improved efficiency.
Key Words: Standard, Order sets, Emergency department, Disease, Time management.