Formatting Multi-order Order Sets
By Sue Rollins
The use of order sets in the electronic world of order entry has been well documented. The efficacy and adoption of the order sets is dependent on the
involvement of the clinician in the development and configuration of the order sets. If the providers who are expected to use the order sets are involved in
planning and creation, then they will, most likely, meet the needs of those providers. Both content and layout are important considerations to take into account
when decisions are made. Providers have strong and definite reasons for why and how they place orders. Often those reasons are not readily apparent to those
configuring the system. Decisions made by the provider and decisions made by the analyst may not always be based on the same information. A blending of both
decision-making rationales must take place and the analyst needs to make that a priority.
Content
Often there are paper forms of the order sets which are being placed into the electronic system. Prior to configuration in the system a thorough review and update
of the orders should be performed. Two questions, “is there a better way” and “is there a less expensive alternative” should be applied to all orders. This
allows for changes in practice and procedure. In today’s world of cost containment it also allows for the review of pharmacy items which will provide the best
patient care, yet control the cost of that care.
Layout
Fields on order forms drive which columns are found on order set forms. Naturally the required fields are the most imperative, but key informational fields are
also important. Visual cues to these key fields can play an essential part in the configuration. This is done through the application of appropriate standards to
the design layout of fields. Standards such as: which columns are present, the location of the columns, and appropriate width of the columns. Selecting the
appropriate orders for each grid, only those that are related, will also make the layout appear clean. Too many “gray” spaces have the potential of creating
confusion for the end user and increasing the possibility for error. Below are some examples of correct and incorrect grid configuration. The first set shows a
single order form and how that form appropriately shows in an order set grid.
Below is a grid that tries to put dissimilar orders into one order grid creating excessive gray space. The better way to handle this would be to put the pulse
ox order into its own grid with other similar orders, or alone. However, some clinicians refrain from doing this in order to decrease the number of grids.
Order sets need not be intimidating or difficult. Including the correct people in the design and applying the correct standards to the configuration will
result in the development of an accurate and useful order set, which will assist providers, nurses, and ancillary departments in delivering the most comprehensive
and cost effective care available. Including these providers means involving them in the development of the content, structure, and function of the order sets.
From start to finish they should be a part of selecting the content, having that content vetted through a committee of their peers and validating the design and
function for each order set. This takes time and dedication to the process. This is not something that can happen overnight, but is a long term commitment to
the development of each order set.
If you would like more information on formatting standards to ensure end-user compliance please contact VCS at 610.444.1233 or vcs@getvitalized.com.