Abstract

Background

Wrong patient selection errors may be tracked by retract–reorder (RAR) events. The aim of this quality improvement study was to assess the impact of reducing the number of concurrently open electronic health records from 4 to 2 on RAR errors generated by a tele-critical care service.

Methods

The study encompassed 32 months before and 21 months after restriction. Chi-Square test of proportions and T statistical process control chart for rare events were used.

Results

There were 156 318 orders with 57 RAR errors (36.5/100 000 orders) before restriction, and 122 587 orders with 34 errors (27.7/100 000 orders) after. Rates were not statistically different (P = .20), but analysis was underpowered. When plotted on a T control chart, random variation was detected between RAR errors.

Conclusion

We found no significant difference in RAR errors in the tele-critical care setting after open record limitation. Other strategies should be studied to reduce wrong patient selection errors.

中文翻译：

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限制远程重症监护环境中打开记录的数量与撤回-重新排序错误之间的关联

摘要

背景

撤回-重新排序 (RAR) 事件可能会跟踪错误的患者选择错误。这项质量改进研究的目的是评估将同时打开的电子健康记录的数量从 4 个减少到 2 个对远程重症监护服务产生的 RAR 错误的影响。

方法

该研究包括限制前 32 个月和限制后 21 个月。使用比例卡方检验和罕见事件的 T 统计过程控制图。

结果

限制前有 156 318 个订单有 57 个 RAR 错误（36.5/100 000 个订单），限制后有 122 587 个订单有 34 个错误（27.7/100 000 个订单）。发生率没有统计学差异（P  = .20），但分析效力不足。当绘制在 T 控制图上时，在 RAR 错误之间检测到随机变化。

结论

在开放记录限制后，我们发现远程重症监护环境中的 RAR 错误没有显着差异。应研究其他策略以减少错误的患者选择错误。