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J Hosp Med. 2009 Feb;4(2):90-6. doi: 10.1002/jhm.403.

Standardized admission order set improves perceived quality of pediatric inpatient care.

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Division of General Pediatrics, Mattel Children's Hospital, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California 94143-0110, USA.



Few studies exist on the ability of standardized preprinted order forms to improve patient care.


To examine resident-perceived effects of introducing a pediatric admission order set (PAOS) on the quality of inpatient care.


Cross-sectional study.


University of California, Los Angeles (UCLA) Children's Hospital, a nonprofit, tertiary-care teaching hospital and major referral center with approximately 3,000 admissions per year.


A total of 97 pediatric residents (PL-1, n=34; PL-2, n=33; and PL-3, n=30) who did the vast majority of the inpatient admissions.


Residents were asked to rate the PAOS overall and with respect to 9 specific dimensions using a 5-point Likert scale.


Overall, 89% of respondents approved of the PAOS, 58% reported using it >or= 90% of the time, and all said that they would recommend it to their colleagues. Eighty-four percent thought that it improved inpatient care, and 75% thought that medical errors were reduced. Eighty-eight percent reported that the PAOS saved time; 93% said it was convenient; and most reported less need for clarification with secretaries (81%) and nurses (82%). In multivariate regression analyses, the only predictor of overall rating was whether the PAOS improved inpatient care (P=0.04). Improved patient care, meanwhile, was predicted by whether the PAOS was comprehensive (P=0.01), reduced medical errors (P=0.01), and required less clarification with nurses (P=0.01).


A standardized admission order set is a simple, low-cost intervention that residents believe may benefit patients by reducing medical errors and expediting high-quality care.

[Indexed for MEDLINE]

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