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BACKGROUND Medication errors are common, and while most such errors have little potential for harm they cause substantial extra work in hospitals. A small proportion do have the potential to cause injury, and some cause preventable adverse drug events. OBJECTIVE To evaluate the impact of computerized physician order entry (POE) with decision support in(More)
PURPOSE To determine the impact of giving physicians computerized reminders about apparently redundant clinical laboratory tests. SUBJECTS AND METHODS We performed a prospective randomized controlled trial that included all inpatients at a large teaching hospital during a 15-week period. The intervention consisted of computerized reminders at the time a(More)
PURPOSE To identify ancillary tests for which there are criteria defining the earliest interval at which a repeat test might be indicated, to determine how often each test is repeated earlier than these intervals and, if repeated, provides useful information. SUBJECTS AND METHODS We performed a retrospective cohort study of 6,007 adults discharged from a(More)
OBJECTIVE To evaluate the effect of an automatic alerting system on the time until treatment is ordered for patients with critical laboratory results. DESIGN Prospective randomized controlled trial. INTERVENTION A computer system to detect critical conditions and automatically notify the responsible physician via the hospital's paging system. PATIENTS(More)
BACKGROUND Vancomycin-resistant enterococci represent an increasingly important cause of nosocomial infections. Minimizing vancomycin use represents a key strategy in preventing the spread of these infections. OBJECTIVE To determine whether a structured ordering intervention using computerized physician order entry that requires use of a guideline could(More)
OBJECTIVE The purpose of the study is to determine how frequently critical laboratory results (CLRs) occur and how rapidly they are acted upon. A CLR was defined as a result that met either the critical reporting criteria used by the laboratory at Brigham and Women's Hospital or other, more complex criteria. DESIGN This is a retrospective cohort study in(More)
BACKGROUND The computerized display of charges for ancillary tests in outpatients has been found to affect physician-ordering behavior, but this issue has not been studied in inpatients. OBJECTIVE To assess whether the computerized display of charges for clinical laboratory or radiological tests affected physician-ordering behavior. PATIENTS AND METHODS(More)
BACKGROUND Digoxin level determinations can be useful clinically in patients receiving digoxin therapy but are sometimes misused. METHODS Explicit appropriateness criteria were adapted from previously published criteria and revised using local expert opinion. They were then used to evaluate the appropriateness of random samples of inpatient and outpatient(More)
OBJECTIVE Our goal was to evaluate trends in the use of radiology with inpatients in the 10-year period of 1984-1993. MATERIALS AND METHODS We retrospectively reviewed administrative data from a 751-bed, tertiary care hospital between October 1, 1983, and September 30, 1993 (Fiscal years 1984-1993). We coded each study by imaging technique: CT, MR(More)
We established criteria for appropriate use of the prostate-specific antigen (PSA) assay and used them to evaluate PSA test utilization at 1 tertiary care institution. During a 6-month period, 2,330 PSA results were reported for outpatients and 95 for inpatients. We reviewed medical records for a random sample of 338 outpatient results (14.51%) and all 95(More)