Order Sets in Health Care: A Systematic Review of Their Effects

Abstract

The benefits of order sets remain eminently plausible, but given the paucity of high quality evidence, further investigations to formally evaluate the effectiveness of order sets would be highly valuable.

Gaps in the Inpatient Management of Chronic Obstructive Pulmonary Disease Exacerbation and Impact of An Evidence-Based Order Set

“…Although the content of the order sets was identical, it is possible that these two media have different effects. However, previous studies have demonstrated similar improvements in specific elements of care addressed with paper (24,25,47) and CPOE-based (34,38) order sets. Although the use of CPOE itself may have had an impact on care independent of the order set, our CPOE system did not provide any decision support except for medication interaction and allergy warnings, which would not be expected to improve the outcomes that we observed to improve (48).…”

Standard admission order sets promote ordering of unnecessary investigations: a quasi-randomised evaluation in a simulated setting

“…First, given that order sets are generally regarded as clinical guideline-consistent,2 blood  work on an order set may be misinterpreted as a prompt rather than simply an option. Second, more cognitive effort is involved in stewardship of blood work compared with selecting multiple checkboxes.…”

Using ‘nudge’ principles for order set design: a before and after evaluation of an electronic prescribing template in critical care

“…Computerised order sets have been used in hospitals for some time but high quality evidence of benefit is lacking 1. While it is known that the use of defaults can enhance the effectiveness of order sets,13 few studies have specifically evaluated this approach.…”

“…Systematic reviews have shown that the use of order sets can lead to positive outcomes but high quality evidence of benefit is lacking 1. The design of these systems is not well studied and many are used with a configuration that may not be optimal for the implementation of desired interventions.…”