Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021;26(5):491-496.
doi: 10.5863/1551-6776-26.5.491. Epub 2021 Jun 28.

Design, Implementation, and Evaluation of Compliance With Pharmacy Workflow During a Pediatric Oncology Computerized Provider Order Entry (CPOE) Launch

Devin R Dinora, Joshua J Elder, Kyle A Harwood

Design, Implementation, and Evaluation of Compliance With Pharmacy Workflow During a Pediatric Oncology Computerized Provider Order Entry (CPOE) Launch

Devin R Dinora et al. J Pediatr Pharmacol Ther. 2021.

Abstract

Objective: There is a lack of published literature detailing how computerized physician order entry (CPOE) pharmacy workflow is designed and implemented. The intent of this project was to design, implement, and assess compliance with the pharmacy workflow required for launching CPOE to improve the safety and efficiency of chemotherapy order entry for pediatric patients.

Methods: This process implementation project took place in 2 phases, which included the design and implementation of pharmacy workflow education, and retrospective chart review of patients who received chemotherapy ordered through CPOE. An anonymous survey was also distributed to pharmacy staff, nurses, and physicians, and an assessment of any CPOE-related safety reports was completed.

Results: Eighty-three patients received intravenous and/or intrathecal chemotherapy ordered via the CPOE software, Beacon, within the electronic medical record system, Epic, in the first 30 days post-launch across both the inpatient and outpatient settings. Overall compliance with the CPOE workflow for entering chemotherapy plans was 77% and >66% compliance with the order preparation process. Pharmacists provided an average of 1.6 interventions per review. The pharmacy was able to prepare chemotherapy within the allotted institutional time benchmarks in most cases. An overall combined multidisciplinary survey response rate of 30.6% was achieved. Twenty-eight Beacon-related patient safety reports were filed in the first 2 weeks post-launch.

Conclusions: The Beacon launch at this single pediatric institution was successful, and the pharmacy workflow was shown to greatly affect the overall success of the launch of CPOE. The careful prospective design, education, implementation, and retrospective review of the pharmacy workflow is key to process implementation related to chemotherapy CPOE.

Keywords: CPOE; Epic Beacon; chemotherapy; computerized physician order entry; oncology.

PubMed Disclaimer

Conflict of interest statement

Disclosures. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. Devin Dinora, Joshua Elder, and Kyle Harwood had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

References

    1. Goldspiel B, Hoffman JM, Griffith NL et al. ASHP guidelines on preventing medication errors with chemotherapy and biotherapy. Am J Health Syst Pharm. 2015;72(8):6–35. - PubMed
    1. Aziz MT, Ur-Rehman T, Qureshi S, Bukhari NI. Reduction in chemotherapy order errors with computerised physician order entry and clinical decision support systems. Health Inf Manag. 2015;44(3):13–22. - PubMed
    1. Chung C, Patel S, Lee R et al. Implementation of an integrated computerized prescriber order-entry system for chemotherapy in a multisite safety-net health system. Am J Health Syst Pharm. 2018;75(6):398–406. - PubMed
    1. Crespo A, Redwood E, Vu K, Kukreti V. Improving the safety and quality of systemic treatment regimens in computerized prescriber order entry systems. J Oncol Pract. 2018;14(6):393–402. - PubMed
    1. Bellamy L, Purcell WT. One institution's experience with implementation of Epic/Beacon: lessons learned. Oncology (Williston Park) 2014;28(2):105–108. - PubMed

LinkOut - more resources