Implementation and Adoption of an Order-Based Surgical Case Request Tool across Subspecialty Clinics

Andrew P. Bain; Alyssa Low; Robert W. Turer; Jonathan E. Reeder; Brandon R. Bruns; Derek Ngai; Christoph U. Lehmann; Hongzhao Ji

doi:10.1055/a-2564-7405

Applied Clinical Informatics, Inhaltsverzeichnis

Appl Clin Inform 2025; 16(03): 689-697
DOI: 10.1055/a-2564-7405

Research Article

Implementation and Adoption of an Order-Based Surgical Case Request Tool across Subspecialty Clinics

Andrew P. Bain

¹Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, United States

²Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States

,

Alyssa Low

³Department of Otolaryngology, UT Southwestern Medical Center, Dallas, Texas, United States

,

Robert W. Turer

²Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States

⁴Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, Texas, United States

,

Jonathan E. Reeder

²Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States

⁴Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, Texas, United States

,

Brandon R. Bruns

¹Department of Surgery, UT Southwestern Medical Center, Dallas, Texas, United States

,

Derek Ngai

²Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States

⁵Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, United States

,

Christoph U. Lehmann

²Clinical Informatics Center, UT Southwestern Medical Center, Dallas, Texas, United States

⁵Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas, United States

,

Hongzhao Ji

³Department of Otolaryngology, UT Southwestern Medical Center, Dallas, Texas, United States

› Institutsangaben

Abstract

Background

While computerized provider order entry (CPOE) has become standard for medication, laboratory, referral, and imaging ordering, use in surgical case requests has not been well-described. At a large county hospital, many surgical clinics used a variety of workflows for case requests, leading to data duplication and data storage outside of the electronic health record (EHR).

Objective

We hypothesized that a provider-entered order-based case request (OBCR) tool would improve data entry efficiency and provide a more comprehensive EHR audit trail.

Methods

We implemented an OBCR tool across surgical clinics at a large safety-net hospital system. The existing workflow, whereby clinic managers created operative cases within the EHR after provider communication, remained available. We analyzed all cases requested via old or new workflows for 6 months after the go-live of the tool.

Results

From 2022 to 2023, managers created 7,226 operative case requests across 19 surgical clinics, 158 faculty surgeons, and 1,737 procedure combinations. Most cases (4,585, 63%) were created via OBCR. Clinic OBCR use ranged from 2 to 97% of created cases. With OBCR, case information was entered earlier, resulting in significantly increased time from case creation to scheduling, 12.0 versus 0.7 days, respectively (p < 0.001). Concordantly, mean time from creation to completion increased from 35.4 to 54.6 days (p < 0.001). Rates of “voided cases” decreased in the new workflow (1.9 vs. 4.5%, p < 0.001).

Conclusion

Most surgical clinics at our institution adopted the OBCR tool, facilitating earlier operative case entry with lower void rates. This streamlined case request approach improves preoperative planning and reduces data entry redundancy. The OBCR system also enabled the data collection needed for robust reporting and identification of clinics in need of support or workflow optimization.

Keywords

surgical case request - surgery scheduling - CPOE - surgical informatics

Volltext

Referenzen

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