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Quality Update
What an Idea!
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| Neonatologist Christoph Lehmann found a way for physicians to electronically place orders and catch errors quickly. |
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Neonatologist Christoph Lehmann was finding too many problems in ordering medication for infants in the neonatal intensive care unit (NICU). But with equal doses of entrepreneurial enthusiasm, computing programming and ingenuity, Lehmann found a solution. Why not use a common Web development tool to create a system allowing physicians to place their orders electronically and catch errors quickly—before they affected the unit’s tiny patients?
In the NICU most infants typically receive parenteral (intravenous) nutrition for days or weeks. These nutrition orders may include up to 15 ingredients, calculated on the basis of the infant’s weight and other key factors.
With the help of a pediatric pharmacist and a nutritionist, Lehmann developed an electronic addition to the pharmacy order system that he calls the total parenteral nutrition calculator. Based on certain rules and logarithms, it automatically computes factors involved in newborn medications and issues warnings—highlighted in either red or orange—if something is amiss. It also provides a description of the mistake in the nutrition order. Physicians can use the calculator on any public workstation computer or on their own desktops.
Lehmann’s simple solution has cut the NICU’s medication errors by 89 percent. And because the program does all the calculations, Lehmann says this electronic ordering form has reduced the time doctors spend on orders from about 10 to two minutes per patient. It took Lehmann’s team just three weeks to develop the prescription calculator which involved no costs other than their time.
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