A Computer Audit to Improve ER Drug Prescribing - Executive Summary

摘要

This report describes the effectiveness of a computer-assisted patient care surveillance system in improving emergency room (ER) drug prescribing. The care of patients treated for open soft tissue injuries in three hospital ERs was concurrently reviewed during an 18 month period using a clinical algorithm for laceration care previously developed. This algorithm includes recommendations concerning the use of topical, oral, intramuscular, and intravenous antibiotics, local anesthetics, and tetanus toxoid and hyperimmune globulin. This study involving three Connecticut hospital emergency rooms has shown that a clinical algorithm (OPCARE) in conjunction with daily computer feedback to physicians is capable of identifying drug prescribing problems and modifying clinical practices. These results also show the feasibility of using OPCARE in a community hospital as well as large medical centers. While physicians were not universally enthusiastic about having their clinical practices scrutinized by the system, they usually acknowledged the system's educational value. Use of tetanus toxoid improved significantly following implementation of OPCARE, but other drug treatments were apparently unaffected.