Turning doctors into leaders

Partners HealthCare System, Boston, USA.
Harvard business review (Impact Factor: 1.27). 04/2010; 88(4):50-8.
Source: PubMed
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    • "The reason for this was because she pointed out that various physicians were giving conflicting information and she wanted to be sure they actually communicated with each other. According to Lee (2011) this is exactly why a new kind of leader is desperately needed (one that insists on EBML, can organize doctors, improve certain processes and most of all get rid of all the dysfunction that takes place). Gawande (2009) has spent years in his determination to fix healthcare. "
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    • "Prior work shows that communication mistakes in hospitals happen most often at boundaries (Tucker, 2004; Gittell, 2002; Argote, 1982). Because boundaries grow exponentially as more subspecialists with deep knowledge in narrow areas become involved in delivering care (Lee, 2010), IT that codifies knowledge and processes and facilitates coordination should increase efficiency (Davidson and Chismar, 2007; Gattiker and Goodhue, 2004). Although previous work has shown that routines can be a double-edged sword by creating rigidities (Holweg and Pil, 2008; Leonard-Barton, 1992), CPOE promotes routines through suggestions and warnings, but allows physicians to make all final decisions, thus allowing for breaking routines where appropriate (Davidson and Chismar, 2007). "
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    ABSTRACT: Doctors’ orders entered with Computerized Physician Order Entry (CPOE) systems are designed to enhance patient care by standardizing routines that are intended to improve quality of healthcare. As with other health information technology (IT) performance studies, literature shows conflicting results regarding the CPOE–performance relationship. By adopting a more nuanced perspective and employing not just adoption but extent of use of CPOE, we first examine whether or not CPOE use improves patient satisfaction. Next, given that CPOEs are implemented in the backdrop of other hospital IT infrastructure, we examine how IT infrastructure impacts the relationship between CPOE use and satisfaction, testing both a complementary and substitution perspective. Finally, we examine the differential impact of CPOE use between academic and non-academic hospitals. Using data from 806 hospitals nationwide, we find a positive relationship between extent of CPOE use and patient satisfaction. Contrary to extant research, our results suggest this relationship is stronger in non-academic hospitals. We also find evidence that a hospital's IT infrastructure substitutes for CPOE use in its effect on patient satisfaction.
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