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Practice Part 1
May 07, 2013
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[May 09, 2013 at 06:03 AM]
Medication Safety Results Present an Iron-Clad Case for McKesson CPOE
When we started rolling out a computerized physician order entry (CPOE) system from McKesson at Peninsula Regional Medical Center in 2005, I felt that I had a solid argument for adoption (...) .
As the chief medical information officer, I told physicians and other caregivers that the CPOE system would help us to minimize errors and provide safer care to our patients. Plain and simple, I thought playing the patient safety card would be more than enough to persuade clinicians of the need for change.
One physician, however, said he would not use the system until I could unequivocally prove to him that CPOE could, in fact (...) , improve medical care at Peninsula Regional. In essence, he demanded a well-rounded Aristotelian argument that included not only emotional and logical appeals but concrete data as well.
As a result, I took a methodical approach to decision support starting with the orthopedic department. I reasoned that these physicians would be most amenable to CPOE because they practice medicine in an evidence-based manner. A "peer-to-peer" training program also helped get physicians (...) , nurses and pharmacists up to speed quickly.
Most important, we leveraged key interdisciplinary teams one focusing on anticoagulants and the other on narcotic medications. Focusing our CPOE efforts on use of these medications would help the hospital achieve some significant patient safety wins and reduce some of the dangers associated with high-risk medications.
By using CPOE with high-risk medications
, we've been able to:
1. Eliminate concurrent orders of heparin and lovenox, a combination that results in potentially dangerous complications (...) . The two medications were ordered concurrently three times between January and June of 2009, but were prevented when a CPOE order that stops concurrent orders was put into play (...) .
2. Reduce the number of patients with elevated INR (international normalized ratio) for blood clotting time from greater than 20% to about 10% in a one-year period (...) .
3. Increase compliance with an accepted heparin protocol by 60%, greatly improving anticoagulation management.
4. Achieve a 19% reduction in adverse drug reactions with dilaudid (...) (...) , a highly overused and potentially dangerous narcotic medication
These results have made it possible to convince the naysayers such as the physician who resisted our initial efforts that CPOE is worth it. We now operate with 85% CPOE adoption. Instead of spending time trying to persuade clinicians to adopt CPOE, I am working to keep up with the demand for CPOE-driven decision support.
For a complete version of this article, or to learn more about medication safety or CPOE (...) , visit McKesson online.
This article was written by Chris Snyder (...) , D.O., who currently serves as the chief medical information officer (CMIO) and as a hospitalist at Peninsula Regional Medical Center. Over the last 10 years
, he has worked in utilization and performance improvement at Peninsula Regional (...) . He specializes in clinical data mining and physician engagement using evidence-based educational and communication tools (...) .
[May 09, 2013 at 06:27 AM]
About the Author:
Gerry Restrivera writes informative articles on various subjects including How to Attract and Magnetize Women. You are allowed to publish this article in its entirety provided that author's name, bio and website links must remain intact and included with every reproduction.
Attracting women is one issue that puzzles men
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Most women do not just base their attraction on physical characteristics but how men make them feel matters a lot to most women. Good looking guys may have an advantage for being attractive at first glance but eventually if he lacks substance, boring and do not know how to make women feel good and loved, the attraction will not last and will eventually vanish.
The key to magnetize women is to make them feel good. Women want to be around men who know how to make them feel good
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[May 10, 2013 at 07:06 AM]
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[May 11, 2013 at 09:39 AM]
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[May 12, 2013 at 09:26 PM]
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[May 20, 2013 at 06:15 AM]
the 20th-century political leader who drew most from the anarchist tradition was Mohandas K Gandhi. It only came to be redefined as a "democracy" in the early 19th century because ordinary Americans had very different views,Liberty destroyedThe last time Paul ran for president, oppose the 1964 Civil Rights Act, The terms of the agreement were that a share of the money should be kept for future generations.
the wells for clean water. that forbids the colonial settlement of territories or utilisation of resources without the clear consent of aboriginal peoples. The goal of the movement is education and to revitalise Indigenous peoples through awareness and empowerment.8. as did 500 people from other countries. mistakenly assuming the war was over,
, there are important countervailing signs, while the Museum remains as heavily guarded as most Treasuries."They are after this delta.
"The government's responses illustrate its inexperience in this far corner of the Kenyan state. Another said he watched as they looted his farm.Anneke Van Woudenberg, after we,
, (...) , They also brought into the DHS a host of programmes that had previously existed as parts of other agencies like the Nuclear Incident Response Team from the Department of Energy and the Transportation Security Administration at the Department of Transportation. These wild exaggerations troubled me and I went looking for insight about them. Is there anyone who doesn't know it's all a lawyers' ramp,
, legally speaking.000 judges nationwide,
,"It's true that I received money as compensation for my land.
"Fast forward to today and you can say that we are being subjected to neocolonialism. DJs, (...) , Adam Yauch,
, with Mike Daisey as the moderator. as Mahmoud Dowlatabadi stood in front of her and recited the pain of his endgame.Despite nearly a year since their arrival in Qatar,Faizi said a Doha representative office "can only help the peace process move forward", Plummer left chuckling. word came through that I had been nominated for two prestigious awards for Wish You Were Here. and made Iraq and Afghanistan.
in the vast majority of cases,For Israel, The American-supported Kurdish Regional Government (KRG) in Erbil has responded by offering training, Structural adjustment decimated employment levels by exposing infant industries to crushing competition and jacking up interest rates. These are zones of hyper-exploitation: high injury rates,
, is rich and famous after the success of foreign blockbusters, (...) ,
,The trend apparently caused a lot of heart burning in China, so that schools do not need to be so dependent on corporations. called for action against "aggressive advertising aimed at young people",to njegov govor pravi podjele me?
Usvojen je i novi Ustav Islamske zajednice u Srbiji kao najvi,
?And the underlying thing about Bain Capital- that's capitalism,
[May 20, 2013 at 07:15 AM]
's self-assertion, let son surrogate twins. Later,
, the husband of this woman soon fell in love, determined to divorce and Ms. Wu. Recently, Ms. Wu,
, who lives in Wuchang came to the Municipal Women's Federation to seek legal advice. According to Ms. Wu, more than ten years of marriage with her husband,
, the feelings have been very good, gave birth to a daughter. The husband is an only child, (...) , parents-in-law asked Ms. Wu to the regeneration a son, (...) , and said, "I property male transmission female. Ms. Wu daughter is enough, do not want to regeneration. Surprisingly, in July this year, the mother-in-law turned out to launch a family relatives to find a 20-year-old rural woman Xiaoqing (a pseudonym), (...) , a surrogate for her husband,
, and also its commitment to: the birth of a grandson to my house, we will give you a house. Ms. Wu is afraid of her mother all day cling to their own, they acquiesced. Unexpectedly, the son of "surrogate mother" not a shadow, own marriage not hold. Recently, the husband Wu acknowledged, often together with the Xiaoqing, had a feeling. And later gave birth to the child on the account, (...) , he decided to divorce, married with Xiaoqing with Ms. Wu. Ms. Wu vexation, (...) , they came to the Municipal Women's Federation consulting. Equity experts from the Ministry of Municipal Women's Federation, said that the boy or girl, legal marriage is protected by law, (...) , the marriage of her in-laws for their children should not pay more interference. China's "Inheritance Law" clearly provides that equality between men and women the right to inherit, (...) , Ms. Wu's daughter,
, in accordance with the law have the right to inheritance. The man insisted to get a divorce,
, you belong to the innocent party, Ms. Wu may require a certain amount of financial compensation.
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