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There is a developing trend among the hospital administrators of investing and implementing a computerized physician order entry (CPOE) system. These efforts are aimed at improving safety and accuracy of medical data, information, and reports. A CPOE system is designed to solve such problems as poor and illegible handwriting on prescriptions and errors in data entry. In order to solve these issues, all physicians’ prescriptions for medicines and treatment would be entered into the hospitals’ IT network. Above all, all entries in the computerized system would be available to all hospital’s staff. Secondly, a computerized system will help improve the accuracy of medical records, because the system can catch prescription-related errors. They include incorrect dosages, redundant duplications, and other adverse effects occurring in multiple medications prescribed to the patient. However, there is evidence showing that a computerized physician order entry system does not eliminate medical errors, but it, actually, increased adverse outcomes. Some of the identified problems include incorrect dosage information, patient confusions and discontinuation failures. These problems show that something wrong has happened despite a computerized system having been implemented.
How Technology Can Lead to More Mistakes in Hospitals
Most chief administrators in hospitals have already implemented technological systems to solve medication-related errors. However, a case study of Springfield General Hospital shows that, on the contrary, technology may have increased errors, which could have caused more harm to patients (Spector, 2013). More precisely, cases of incorrect dosage information, discontinuation failures, and confusion in patients’ records have increased. There are several reasons that could contribute to the failure of technology to eliminate medical mistakes (Bates, 2000). For one, design, implementation, and administration of a computer system is difficult. For instance, different CPOE computer screens offer different colors and typefaces of the same information. As a result, it becomes easier to collect the wrong file, because names and drugs are close to each other (Wrunk, 2000). Moreover, the majority of patients’ names are grouped in an alphabetical order rather by house rooms. Such organization enhances misinterpretations particularly when the physicians are switching among the screens (Spector, 2013).
In addition, some physicians may lack the full understanding of how the CPOE functions. As a consequence, some staff may be forced to operate the computer system simply to make managers happy (Wrunk, 2000). In this case, it is easy to make errors, because the staff may be more concerned about staying within the organization than the competency of accuracy. The situation becomes worse due to the hidden elements that can overwhelm the system. For instance, hidden parts can hinder the cross-record comparison, which ensures that the records are accurate (Bates, 2000). In addition, the computerized system in the Springfield General Hospital could lack a central storage system. The files could be stored in different locations thereby making it more difficult to collect and merge specific information that would enhance the provision of healthcare. Secondly, the lack of a centralized database could force nursing and pharmacy staff to use manual records for counter-checking, which may cause errors in drug safety and administration (Wrunk, 2000).
Theories of Change Implementation Necessary for Organizational Change
When the administrators of the Springfield General Hospital decided to implement a computerized system, the environment went through a major transformational change. In the future, in order to solve the problems that the current system has faced, the administrators should adopt some theories of change implementation (Spector, 2013). The first theory involves treating the hospital as an organization with an open system. In this case, it will be easier to implement the organizational development and improve the interaction of the external environment with internal elements (Bates, 2000). The open system will enhance the effectiveness of both the actions of the staff and interaction that occurs at multiple levels. More specifically, the theory of organizational development of an open system fosters effectiveness of the employees and the tasks they perform, the intended culture, and the strategy of the organization as well as its external environment (Spector, 2013). An open system works under the notion that there is no single policy, practice, or action that can work on its own. It requires participation and teamwork in order to enhance shared purposes and responsibilities for interdependent tasks (Bates, 2000).
Change in any organization is a constant occurrence. The objective of change implementation is to scale down, tighten up and implement alternative operational strategies that streamline processes while supporting staff and maintaining the organizational culture (Spector, 2013). Using the case of the Springfield General Hospital, the administration should use a theory based on problem-solving, openness and trust in order to address current problems. In essence, formulating a strategy that will explain the methods of how best to perform after a change will have a positive effect (Bates, 2000). For instance, conflict resolution methods will encourage individuals to articulate their personal points of view while considering the views of others. In addition, the administration should ensure that the change process will instill a sense of ownership, open communication, and collaborative problem-solving. The questions of both what needs to be changed and how the change should be implemented should be addressed (Wrunk, 2000). Therefore, all members should be included into the action planning and implementation efforts. Moreover, using such incentives as employee motivation through training and coaching will help the staff adopt the changes without much resistance. It will also be easier for the employees to develop new behaviors, which will make the implementation process more successful in the long run (Spector, 2013).
Furthermore, task alignment will contribute to change implementation significantly. By following the task alignment approach to change implementation, employees at all levels are motivated to engage in the behavioral change (Wruck, 2000). They learn to appreciate that the change is related to the performance of core tasks of a particular organization. Secondly, by focusing on real business problems, task alignment takes advantage of the existing knowledge and expertise (Spector, 2013). For instance, tangible performance results arise from task-aligned interventions, and efficacy is evident in creating momentum for renewed change interventions. Consequently, task alignment will build commitment to the focus on real and immediate performance problems. The hospital environment is dynamic, and, therefore, task alignment will embed the insights of organizational development and produce outstanding performance (Wruck, 2000). Besides, the employees will have the ability to redefine their roles, responsibilities, and relationships in order to perform those tasks better.
Technological Improvements to Reduce Current Medical Problems at Springfield General Hospital
Despite the drawbacks of implementing a computerized system, the administration of the Springfield General Hospital can make several technological improvements and solve current problems (Bates, 2000). The Management Development and Planning program will play a significant role. Under this system, each job will be assigned a number of points based on such measures of a job as the number of patients. This program will help enhance uniformity and clarity of the patients’ records, which are valuable for solving mistakes of data redundancy (Spector, 2013). It is in the best interest of all health workers to reduce the number of medical errors. Therefore, the implementation of a standardized technology to enhance communication among the staff will come in handy. An effective computerized system will enhance communication, which will, in turn, create checks and balances in the system (Wruck, 2000).
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Several interventions involving new information systems can reduce mistakes in medication considerably. It will include the implementation of a computerized physician decision support, automated dispensing devices, and computerization of medication administration records (Bates, 2000). These new technologies will help reduce such errors as incorrect dosages and duplicated medical records. Additionally, the computerization of ordering will improve patient safety in several ways. First, it will ensure that all orders are structured to include the correct dosage and frequency (Wruck, 2000). Secondly, the information provided by the pharmacists and physicians will be verified for allergies, overdoses, and drug interactions. Eventually, the numbers of errors can be reduced significantly. More importantly, a computerized decision support system is valuable for reducing the frequency of adverse drug events (Bates, 2000). This approach works by helping clinicians integrate key pieces of data that would otherwise be problematic due to the overwhelming stream of data (Wruck, 2000).
In conclusion, there is a trend of implementing computerized systems in hospitals with an aim to solve such problems as illegible handwriting on the prescriptions and errors in data entry. A CPOE system enables those medical records to be available to the whole staff, because they are stored in relational databases. It also helps improve the accuracy of medical records, because the system can catch such prescription errors as incorrect dosages, redundant duplications, and other adverse effects occurring in multiple medications prescribed to the patient. However, in some cases, technology has led to more mistakes when used in medical environments. There have been increased cases of incorrect dosage information, discontinuation failures, and confusion in patients’ records. These errors are increasing, because the design, implementation, and administration of a computerized system is difficult. There are hidden errors that affect the functioning of the system without the full knowledge of the operator. In order to enhance the success of technology in hospitals, the administrator should apply theories that promote a clear understanding of the effects of the system on existing activities. Moreover, implementing a Management Development and Planning program will help reduce cases of data redundancy, because the system will be designed to meet the size of the streaming jobs.
