Skip to main content Accessibility help
×
×
Home

ORDER SETS IN HEALTH CARE: A SYSTEMATIC REVIEW OF THEIR EFFECTS

  • Alvita J. Chan (a1), Julie Chan (a2), Joseph A. Cafazzo (a3), Peter G. Rossos (a3), Tim Tripp (a4), Kaveh Shojania (a5), Tanya Khan (a6) and Anthony C. Easty (a3)...

Abstract

Objectives: Order sets are widely used in hospitals to enter diagnosis and treatment orders. To determine the effectiveness of order sets in improving guideline adherence, treatment outcomes, processes of care, efficiency, and cost, we conducted a systematic review of the literature.

Methods: A comprehensive literature search was performed in various databases for studies published between January 1, 1990, and April 18, 2009. A total of eighteen studies met inclusion criteria. No randomized controlled trials were found.

Results: Outcomes of the included studies were summarized qualitatively due to variations in study population, intervention type, and outcome measures. There were no important inconsistencies between the results reported by studies involving different types of order sets. While the studies generally suggested positive outcomes, they were typically of low quality, with simple before-after designs and other methodological limitations.

Conclusions: The benefits of order sets remain eminently plausible, but given the paucity of high quality evidence, further investigations to formally evaluate the effectiveness of order sets would be highly valuable.

Copyright

References

Hide All
1.Asaro, PV, Sheldahl, AL, Char, DM. Embedded guideline information without patient specificity in a commercial emergency department computerized order-entry system. Acad Emerg Med. 2006;13:452458.
2.Biviano, AB, Rabbani, LE, Paultre, F, et al.Usefulness of an acute coronary syndrome pathway to improve adherence to secondary prevention guidelines. Am J Cardiol. 2003;91:12481250.
3.Bobb, A, Payne, T, Gross, P. Viewpoint: Controversies surrounding use of order sets for clinical decision support in computerized provider order entry. J Am Med Inform Assoc. 2007;14:4147.
4.California Acute Stroke Pilot Registry Investigators. The impact of standardized stroke orders on adherence to best practices. Neurology. 2005;65:360365.
5.Campbell, EM, Sittig, DF, Ash, JS, et al.Types of unintended consequences related to computerized provider order entry. J Am Med Inform Assoc. 2006;13:547556.
6.Chapman, G, Curtas, S, Meguid, MM. Standardized enteral orders attain caloric goals sooner: A prospective study. JPEN J Parenter Enteral Nutr. 1992;16:149151.
7.Chisolm, DJ, McAlearney, AS, Veneris, S, et al.The role of computerized order sets in pediatric inpatient asthma treatment. Pediatr Allergy Immunol. 2006;17:199206.
8.Clinical Quality Improvement Network Investigators. Influence of a critical path management tool in the treatment of acute myocardial infarction. Am J Manag Care. 1998;4:12431251.
9.Debrix, I, Tilleul, P, Milleron, B, et al.The relationship between introduction of American society of clinical oncology guidelines and the use of colony-stimulating factors in clinical practice in a Paris university hospital. Clin Ther. 2001;23:11161127.
10.Elsasser, GN, Goodman, MD, Destache, CJ, et al.Preprinted risk assessment and prophylaxis order form for venous thromboembolism. Am J Health Syst Pharm. 2007;64:12941298.
11.Garrelts, JC, Meister, A, Bond, J. Effect of preprinted order form on epoetin alfa prescribing. Am J Health Syst Pharm. 2007;64:17321738.
12.Guyatt, GH, Oxman, AD, Kunz, R, et al.What is “quality of evidence” and why is it important to clinicians? BMJ. 2008;336:995998.
13.Healthcare Human Factors, University Health Network. Order sets in healthcare: An evidence-based analysis. http://www.ehealthinnovation.org/?q=node/485 Archived at: http://www.webcitation.org/5oq6cUjsq (accessed September 16, 2010).
14.Hughes, MR, Smith, CD, Tecklenburg, FW, et al.Effects of a weaning protocol on ventilated pediatric intensive care unit (PICU) patients. Top Health Inf Manage. 2001;22:3543.
15.Koplan, KE, Regan, S, Goldszer, RC, et al.A computerized aid to support smoking cessation treatment for hospital patients. J Gen Intern Med. 2008;23:12141217.
16.Micek, ST, Roubinian, N, Heuring, T, et al.Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med. 2006;34:27072713.
17.Miller, SJ, North, GL, Anderson, WD. Parenteral nutrition order form to improve dextrose and lipid use. Am J Hosp Pharm. 1990;47:25152518.
18.Noschese, M, Donihi, AC, Koerbel, G, et al.Effect of a diabetes order set on glycaemic management and control in the hospital. Qual Saf Health Care 2008;17:464468.
19.O'Connor, C, Adhikari, NK, DeCaire, K, et al.Medical admission order sets to improve deep vein thrombosis prophylaxis rates and other outcomes. J Hosp Med. 2009;4:8189.
20.Rosenal, T, Fantin, L, Sinnarajah, A, et al.Optimizing standard patient management through order sets – Impact on care (blood cultures). Stud Health Technol Inform. 2009;143:487495.
21.Theilen, BM, Gritzke, KA, Knutsen, PG, et al.Inpatient glycemic control on the vascular surgery service. Endocr Pract. 2008;14:185191.
22.Thiel, SW, Asghar, MF, Micek, ST, et al.Hospital-wide impact of a standardized order set for the management of bacteremic severe sepsis. Crit Care Med. 2009;37:819824.
23.Thorn, DB, Sexton, MG, Semav, AP, et al.Effect of a cancer chemotherapy prescription form on prescription completeness. Am J Hosp Pharm. 1989;46:18021806.
24.Treece, PD, Engelberg, RA, Crowley, L, et al.Evaluation of a standardized order form for the withdrawal of life support in the intensive care unit. Crit Care Med. 2004;32:11411148.
25.University of Bern. STROBE checklist for cohort, case-control, and cross-sectional studies (Version 4). http://www.strobe-statement.org/index.php?id=available-checklists Archived at: http://www.webcitation.org/5oq5bf0Uv (accessed July 15, 2009).
26.Webb, LZ, Kuykendall, DH, Zeiger, RS, et al.The impact of status asthmaticus practice guidelines on patient outcome and physician behavior. QRB Qual Rev Bull. 1992;18:471476.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
WORD
Supplementary materials

Chan supplementary figures
Chan supplementary figures

 Word (2.1 MB)
2.1 MB
WORD
Supplementary materials

Chan supplementary tables
Chan supplementary tables

 Word (100 KB)
100 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed