Scenario
A nursing director at a 220-bed hospital recently merged with a larger medical center is overseeing the rollout of a new CPOE system. The general units went live last month, and specialty units are scheduled for next month. While most providers are adjusting well, three physicians continue resisting. Instead of using the system, they’ve issued verbal orders, left handwritten notes, or brought in unauthorized order forms. They’ve also pressured nurses to enter orders for them, putting the nurses in a difficult position between following policy and preserving teamwork.
Issues That Occurred During CPOE Implementation
Implementing the Computerized Physician Order Entry (CPOE) system in the hospital has brought about several challenges. Resistance from a subset of physicians is a significant issue during the transition phase. The resistance manifests in various forms, from initial complaints to more subversive behaviors, such as using unauthorized order sheets and coercing nurses to enter orders on their behalf.
Potential Causes of These Issues
The potential causes of such resistance could be multifaceted. Some physicians may resist technology due to a lack of familiarity or discomfort with computers, which can be perceived as a threat to their established practices or autonomy. Others might be concerned about the potential for errors, time consumption, or a perceived lack of direct control over patient care. Additionally, the change might be seen as an imposition without adequate involvement in decision-making, leading to a loss of control or respect.
Evidence-Based Recommendations
A comprehensive approach is necessary to address these issues. It is essential to ensure that adequate training and support are provided to all system users. This could involve one-on-one coaching, peer support programs, and the availability of IT support staff to address technical issues promptly (Kudyba, 2023). The hospital administration should engage with resistant physicians to understand their concerns and work collaboratively to address them, emphasizing the benefits of CPOE for patient safety and care efficiency.
Moreover, involving physicians in the ongoing development and refinement of the CPOE system can help ensure that it meets their needs and is user-friendly. This involvement can foster a sense of ownership and acceptance among the physicians.
Scripture Reference and Application
A scripture reference that relates to the importance of cooperation and working together for the common good is 1Corinthians 12:14-26, which speaks about the body of Christ having many parts, but all its many parts form one body. This analogy can be applied to the hospital setting, wherein each member or department plays a vital role in the overall functioning and success of the institution. It highlights the necessity of collaboration, mutual respect, and understanding to provide the best possible care for patients.
As the hospital prepares for the next phase of CPOE implementation, addressing these issues with a compassionate, understanding, and strategic approach will be critical for the system’s success and the enhancement of patient care.
References
English Standard Version Bible. (2001). ESV Online.
Kudyba, S. (2023). Healthcare informatics: Strategies for the Digital Era. Auerbach Publications.