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Appl Clin Inform 2022; 13(02): 447-455
DOI: 10.1055/s-0042-1745828
Research Article

Clinician Acceptance of Order Sets for Pain Management: A Survey in Two Urban Hospitals

Yifan Liu
1   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Haijing Hao
2   Department of Computer Information Systems, Bentley University, Waltham, Massachusetts, United States
,
Mohit M. Sharma
1   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Yonaka Harris
1   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
,
Jean Scofi
3   Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
,
Richard Trepp
4   Department of Emergency Medicine, Columbia University, New York, New York, United States
,
Brenna Farmer
3   Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
,
Jessica S. Ancker
5   Department of Biomedical Informatics, Vanderbilt University Medical Center, New York, New York, United States
,
Yiye Zhang
1   Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, United States
3   Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, United States
› Author Affiliations Funding This study was funded by U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality (R03 HS26266).
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Abstract

Background Order sets are a clinical decision support (CDS) tool in computerized provider order entry systems. Order set use has been associated with improved quality of care. Particularly related to opioids and pain management, order sets have been shown to standardize and reduce the prescription of opioids. However, clinician-level barriers often limit the uptake of this CDS modality.

Objective To identify the barriers to order sets adoption, we surveyed clinicians on their training, knowledge, and perceptions related to order sets for pain management.

Methods We distributed a cross-sectional survey between October 2020 and April 2021 to clinicians eligible to place orders at two campuses of a major academic medical center. Survey questions were adapted from the widely used framework of Unified Theory of Acceptance and Use of Technology. We hypothesize that performance expectancy (PE) and facilitating conditions (FC) are associated with order set use. Survey responses were analyzed using logistic regression.

Results The intention to use order sets for pain management was associated with PE to existing order sets, social influence (SI) by leadership and peers, and FC for electronic health record (EHR) training and function integration. Intention to use did not significantly differ by gender or clinician role. Moderate differences were observed in the perception of the effort of, and FC for, order set use across gender and roles of clinicians, particularly emergency medicine and internal medicine departments.

Conclusion This study attempts to identify barriers to the adoption of order sets for pain management and suggests future directions in designing and implementing CDS systems that can improve order sets adoption by clinicians. Study findings imply the importance of order set effectiveness, peer influence, and EHR integration in determining the acceptability of the order sets.

Keywords

order sets - electronic health records - technology acceptance - clinical decision support - opioid

Protection of Human and Animal Subjects

An IRB approval was obtained from Weill Cornell Medicine IRB to conduct this project.


Supplementary Material



Publication History

Received: 24 November 2021

Accepted: 18 February 2022

Article published online:
27 April 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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