Dr. Akwe is the Chief of Hospital Medicine, and Mr. Wallace is a Performance Improvement Coordinator for Specialty Medicine, both at the Atlanta VA Health Care System in Georgia. Dr. Akwe is an Associate Professor of Medicine at the Emory University School of Medicine in Atlanta. Correspondence: Dr. Akwe (joyce.akwe@emory.edu)
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the US Government, or any of its agencies.
Limitations of this study relate to CPRS functions, which must be specifically activated at different VA sites in order to enable the use of these functions. Also, the successful creation of these order sets depended on the information specialist’s knowledge of the capabilities of the CPRS.
Conclusion
Gaps in practice and recommended guidelines can be bridged by creating standardized admission orders embedded with required quality measures. The Atlanta VAMC project showed that the use of a standardized stroke admission order set significantly improved compliance to quality measures for veterans admitted for ischemic stroke management. This is consistent with a study completed in the ED, which showed that for veterans hospitalized for acute ischemic stroke, electronic order set use was associated with increased use of IV tPA.12 Creating order sets can be challenging, but if these barriers can be overcome, with the first order set, similar templates can be used to create order sets for other clinical conditions, such as heart failure, sepsis, and chronic obstructive pulmonary disease exacerbation.
