Physician satisfaction with transition from CPOE to paper-based prescription

International audienceIntroductionIn January 2015, Rouen University Hospital’s information system experienced serious issues. It was necessary to rapidly switch from the computerized provider order entry (CPOE) system towards a paper-based order entry (PBOE) system. This was an opportunity to evaluate prescriber opinion on the two provider order entry (POE) systems.MethodsAll residents were asked to fill an augmented version of the POE satisfaction and usage survey for both POE systems. The results were compared to identify the strengths and weaknesses of each system.ResultsFifty-one respondents had used the CPOE system and the PBOE system. Overall, satisfaction was higher with PBOE than CPOE (odds ratio (OR) = 3.74; p < 0.001). Usability (OR = 4.00; p < 0.001), reliability (OR = 8.54; p < 0.001), time consumption (OR = 0.50; p < 0.05 – survey statement was formulated negatively), and communication with nurses (OR = 14.27; p < 0.0001) reached statistically better agreement. The more experience with CPOE the more residents were disillusioned with the reliability (OR = 6.55; p < 0.01), the usability (OR = 5.68; p < 0.01) and the patient safety (OR = 0.27; p < 0.05 – survey statement was formulated negatively) of CPOE. Although safety issues were reported for both systems, the causes were different; PBOE imposed frequent rewriting of the order while CPOE lack of usability might be unsafe. Another important issue with both POE systems was time consumption.ConclusionResidents did not report any increase in safety issues with the rapid switch from CPOE to PBOE. They even seemed more satisfied with the rollback to paper, which remains a possible degraded mode in case of health information technology collapse

Intérêt et utilisabilité du dossier pharmaceutique en pratique médicale. Enquête auprès de médecins et pharmaciens hospitaliers (étude MATRIX)

International audienceTo evaluate the impact of the pharmaceutical patient record use in emergency, geriatric and anaesthesia and intensive care departments, an experimentation was launched in 2013 in 55 hospitals. The purpose of the study was to assess the opinions of physicians and pharmacists about the benefits and usability of the patient pharmaceutical record

Solving Rostering Tasks as Constraint Optimization

Based on experiences with the ORBISDienstplan-system [Mey97] -- a nurse rostering system that is currently used in about 30 German hospitals -- this paper describes how to use constraint processing for automatic rostering. In practice, nurse rostering problems have many varying parameters: Working time accounts, demands on crew attendance, set of used shifts, working time models, etc. Hence, rostering requires a flexible formalism for representing the variants of the problem as well as a robust search procedure that is able to cope with all problem instances. The described approach differs in mainly two points from other constraint-based approaches [AS99,WH95] to rostering. On the one hand, the used constraint formalism allows the integration of finegrained optimization tasks by fuzzy constraints, which a roster may partially satisfy and partially violate. Such constraints have been used to optimize the amount of working time and the presence on the ward. In contrast, ..