Comparison of Ordering Tools on Adherence to Treatment Protocols in the Emergency Department.

OBJECTIVE:To assess adherence to clinical protocols in the emergency department after the implementation of embedded order panels in the electronic health record.MATERIALS AND METHODS:Due to infrequent use, a subset of order sets were redesigned as embedded order panels in a menu-style quick list. Usage was measured before and after implementation at seven departments.RESULTS:There were 2,247 applicable encounters during the pre-intervention period and 1,723 post-intervention. The use of order sets increased significantly after implementation (14% vs. 33% or encounters, p < 0.001). Traditional order sets required at least seven keystrokes or mouse clicks, while embedded order panels required only two.DISCUSSION AND CONCLUSION:Use of order sets increased after implementation of embedded order panels; however, they were still only used for about one-third of applicable encounters suggesting that more work is needed to increase treatment protocol adherence and electronic health record efficiency.