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Four out of four doctors recommend Patient Order Sets

Posted By Sladjana Markovic On November 30, 2015 @ 4:07 pm In Uncategorized | No Comments

Dr. Shannon Fraser, Chief of General Surgery

Dr. Shannon Fraser, Chief of General Surgery [1]

Dr. Shannon Fraser, Chief of General Surgery

Standardized care: “If, for instance, surgeon A uses one antibiotic and surgeon B uses another, there’s a greater possibility that the right antibiotic at the right time may not be delivered to the patient. Patient Order Sets eliminate this variation and standardize care, making it possible to consistently apply policies and procedures, and making it easier to provide safe, high-quality care.”

The checklist concept: “This tool works as a checklist of all of the different components of care, with a section for each process that we think is important—monitoring vital signs, diet orders, mobilization, pain medication, anti-nausea medication, and so on. At each step, it makes you ask, ‘Did I think about this? Is this really the option I want?’ It doesn’t allow us to turn our brains off. Instead, it cues us to the right questions that we need to ask.”

Dr. Franck Bladou, Chief of Urology

Dr. Franck Bladou, Chief of Urology [2]

Dr. Franck Bladou, Chief of Urology

Making an effort: “Completing the Patient Order Sets and preparing them for use is really critical, because everything will depend on them. Yes, it takes a lot of thought to be sure to include all of the steps that are best for us. And it’s certainly time-consuming. But when we’re done, it will have the potential to simplify work for everybody, while optimizing the safety of patients.”

ERAS protocols: “In surgery, we’re moving toward implementing the international ERAS protocols—Enhanced Recovery After Surgery. By integrating these protocols into the Patient Order Sets, they will be much easier to implement. They optimize every step that the patient goes through before surgery, during surgery and in the post-operative period to improve recovery and avoid side-effects and complications.”

Dr. Gabriella Ghitulescu, Colorectal Surgeon

Dr. Gabriella Ghitulescu, Colorectal Surgeon [3]

Dr. Gabriella Ghitulescu, Colorectal Surgeon

Allowing for exceptions: “The orders will be prepared and printed in a way that will be much easier for nurses to follow, especially when there are exceptions. Invariably, even when you standardize, there are times when an order has to be changed—for example, for certain diabetic patients. With Patient Order Sets, it will be easier for nurses to see where a particular patient is different from all of the other patients with, say, appendicitis or bowel obstruction.”

Updates: “I would encourage my colleagues 100 per cent to be involved. If you put in the necessary work at the beginning, it will pay off. Afterward, the orders will be updated as new evidence comes in, and we’ll also have access to revised Patient Order Sets that are used by many other institutions.”

Dr. Jean-Sébastien Pelletier, General and Hepatobiliary Surgeon

Dr. Jean-Sébastien Pelletier, General and Hepatobiliary Surgeon [4]

Dr. Jean-Sébastien Pelletier, General and Hepatobiliary Surgeon

Major pros, minor cons: “Some people might argue that the Patient Order Sets seem to eliminate the thinking process behind admission orders or post-operative orders or other types of orders. I would argue the opposite—that you still have to go through the mental exercise of reviewing the order and actively deciding if there’s something you want or don’t want. By using the Patient Order Sets, you make sure that you’re not going to miss things that are clinically relevant or important.”

Positive experiences: “During my fellowship in Pittsburgh, we had our own Patient Order Sets, and I found that they were extremely useful and made our lives much easier. I look forward to using them now, because they’ll help us make certain that nothing is missed. I would recommend Patient Order Sets to all of my colleagues.”

 


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