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Order Sets - Saving Lives, Time and Money


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Order Sets - Saving Lives, Time and Money

  1. 1. ORDER SETS Saving Lives, Time and Money
  2. 2.  Medical knowledge is typically contained in guidelines, text books, medical rounds, web pages, pamphlets, etc.  None of this “Referential Knowledge” directly drives the care of patients Knowledge Translation: Typical Approach
  3. 3.  Most treatments provided to patients in hospitals require a physicians order  A doctor will create free text orders completely from memory on a blank order form and submit to nurse for execution A Doctor’s Order: An Essential Step in Hospital Care
  4. 4. HEALTH CARE ORGANIZATIONS ARE COMPLEX Emergency Room Hospital Pharmacy Radiology Intensive Care Unit Laboratory and Blood Work Discharge
  6. 6. ORDER SET BENEFITS Improve Quality – Durable benefit that increases over time – All areas of the organization – Any process impacted by orders Save Time! – Builds capacity and leads to adoption – Clinician satisfaction Improved Resource Utilization – Foundation for successful Computerized Physician Order Entry
  7. 7. THE CHECKLIST MANIFESTO BY DR. ATUL GAWANDE “It’s just too easy for an otherwise competent doctor to miss a step, or forget to ask a question or, in the stress and pressure of the moment, to fail to plan properly for every eventuality. Dr. Atul Gawande visits with pilots and the people who build skyscrapers and comes back with a solution. Experts need checklists. Literally, written guides that walk them through the key steps in any complex procedure.” Author Malcolm Gladwell’s review of New York Times Bestseller “The Checklist Manifesto” by Dr. Atul Gawande
  8. 8. CHECKLISTS ENSURE AVIATION IS ONE OF THE SAFEST INDUSTRIES  USA: 100,000 preventable hospital deaths per year. Equivalent to one major plane crash per day.  Canada: 10,000 preventable hospital deaths per year. Equivalent to one major plane crash per week.
  9. 9. By implementing an order set solution, Grey Bruce Health Network was able to: Reduce its average length of stay from 5.9 days to 4.7 days Reduce its rate of re-admissions with an unrelated diagnosis within one week from 4.8% to 2.5%
  10. 10. Order Set Content – Evidence based and best practice – Up to date – Workflow! – Standardization Order Set Project – Engage physicians – Consensus without wasting time – Support entire team
  11. 11. Order Set Management Software – Track and update content across the organization Order Set Completion – At point of care Order Set Data – Real time – Provider and organizational data – Tool for engagement
  12. 12. “Standardize that which is routine about patient care so that the clinician can focus on what is unique about the individual”
  13. 13. THANK YOU