Ordonnance de départ informatisée : un sondage rétrospectif
Bibliographic record
Abstract
RESUME Objectif : Verifier l’acceptabilite d’un projet pilote d’ordonnances de depart informatisees dans un hopital communautaire francophone d’Ottawa a l’aide d’un sondage rempli en interne par des medecins, des infirmieres, des commis des unites de soins et des patients et a l’externe, par des pharmaciens communautaires. Methode : Un sondage evaluant le degre de satisfaction a l’egard du projet sur une echelle variant de 0 a 10 (10 etant le degre de satisfaction le plus eleve) a ete rempli par les medecins, les commis, les infirmieres et les patients participant au projet pilote d’ordonnances de depart informatisees. A l’externe, nous avons visite toutes les pharmacies communautaires situees dans un rayon de 6 km de l’hopital ainsi que certaines pharmacies de la communaute d’Orleans, puis nous leur avons remis le sondage. Resultats : Trente-cinq pour cent des medecins (15/43) et 67 % des commis (8/12) ont rempli le sondage en interne; aucune infirmiere n’a repondu au sondage. Le pourcentage de satisfaction generale exprime par les medecins etait de 84,7 ± 13,2 %. Les medecins ont estime que le temps requis pour completer l’ordonnance de depart informatisee etait de 4,0 ± 3,2 minutes, ce qui leur permettait de gagner 7,9 ± 5,1 minutes. Les medecins ont rapporte n’avoir trouve aucune erreur sur les ordonnances de depart informatisees. Le degre de satisfaction generale des commis des unites de soins a ete evalue a 92,1 ± 6,4 %. Le temps requis pour imprimer une ordonnance de depart informatisee a ete estime a 2,6 ± 1,2 minutes. Le nombre de patients ayant repondu au sondage etait trop faible pour que nous puissions effectuer une analyse des resultats obtenus. Soixante-dix-huit pour cent des pharmacies visitees (46/59) ont repondu au sondage. De ce pourcentage, 39 % des pharmacies (18/46) avaient deja recu des ordonnances de depart informatisees provenant de notre hopital avant notre visite, alors que 61 % des pharmacies (28/46) n’en avaient pas recu. Le degre de satisfaction generale des pharmaciens ayant recu des ordonnances de depart informatisees etait de 83,5 ± 9,7 % alors que celui des pharmaciens qui voyaient une ordonnance de depart informatisee pour la premiere fois etait de 83,0 ± 17,4 %. De plus, 61 % des pharmaciens qui avaient recu des ordonnances de depart informatisees avant notre visite ont affirme que de telles ordonnances permettaient de reduire le nombre d’appels telephoniques necessaires pour obtenir des clarifications; 67 % n’ont pas trouve d’erreurs sur les ordonnances de depart informatisees qu’ils ont recues. Soixantehuit pour cent des pharmaciens qui n’avaient pas encore recu d’ordonnances de depart informatisees avant notre visite ont affirme que de telles ordonnances permettraient de reduire le nombre d’appels pour obtenir des clarifications; 83 % n’ont pas trouve d’erreurs sur l’exemple d’ordonnance de depart qui leur a ete presente lors de notre visite. Conclusions : Le projet pilote d’ordonnances de depart informatisees a ete tres bien accepte par les medecins, les commis des unites de soins et les pharmaciens communautaires. Le taux de participation des infirmieres et des patients etait insuffisant pour nous permettre d’evaluer leur degre de satisfaction. A la suite de ce projet pilote, les ordonnances de depart informatisees ont ete implantees de facon permanente aux unites de medecine, de sante mentale et de readaptation de l’hopital. ABSTRACT Objective: To evaluate the acceptability of an electronic discharge prescription pilot project at a French community hospital in Ottawa by means of an internal survey of doctors, nurses, unit clerks, and patients and an external survey of community pharmacists. Methods: Doctors, nurses, unit clerks and patients participating in the electronic discharge prescription pilot project used a scale from 0 to 10 to assess level of satisfaction with the project (where 10 indicated greatest satisfaction). In addition, all community pharmacies within a 6-km radius of the hospital and some pharmacies in the community of Orleans were visited and surveys were delivered by hand. Results: Thirty-five percent of doctors approached (15/43) and 67% of clerks (8/12) completed the survey, but none of the nurses did so. The overall satisfaction rate among doctors was 84.7% ± 13.2%. The doctors estimated that it took 4.0 ± 3.2 min to complete the electronic discharge prescription form, which saved them 7.9 ± 5.1 min. Doctors reported no errors on the form. The overall satisfaction among unit clerks was 92.1% ± 6.4%. The time needed to print an electronic discharge prescription form was estimated at 2.6 ± 1.2 min. The number of patients who completed the survey was too low to allow analysis of the results. Seventy-eight percent of the pharmacies visited (46/59) completed the survey. Of these, 39% (18/46) had already received electronic discharge prescriptions from the hospital before the visit; and 61% (28/46) had not received any of these forms. The overall satisfaction rate among pharmacists that had received electronic discharge prescriptions was 83.5% ± 9.7%; the satisfaction rate was 83.0% ± 17.4% for those seeing such a form for the first time. In addition, 61% of the pharmacists that had received an electronic discharge prescription before our visit confirmed that using these prescriptions reduced the number of phone calls required to obtain clarifications; 67% found no errors on the forms they had received. Sixty-eight percent of the pharmacists who had never received an electronic discharge prescription before the survey declared that such forms would allow them to reduce the number of phone calls required for clarifications; 83% found no errors on the sample that they saw during the survey visit. Conclusion: The electronic discharge prescription pilot project was very well accepted by doctors, unit clerks, and community pharmacists. The participation rate for nurses and patients did not allow level of satisfaction to be evaluated. Following this project, electronic discharge prescriptions have been permanently implemented at the medical, mental health, and rehabilitation units of the hospital.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.096 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".