Impact of computerized physician order entry on ED patient length of stay

Abstract

Objectives: We evaluated whether implementation of computerized physician order entry (CPOE) reduces length of stay (LOS) for discharged emergency department (ED) patients.

Methods: Emergency department LOS for discharged and admitted patients were analyzed in a university-affiliated ED before and after introduction of CPOE. Patient demographics and covariates that may affect LOS (mode of arrival, provider staffing, daily census, and admission rate) were measured.

Results: The study included 71,188 patients; 49,175 (69%) were discharged from the ED (28, 687 before and 20,488 after CPOE). Length of stay for discharged patients decreased from 198 to 168 minutes (difference of -30; 95% confidence interval [CI], -28 to -33), whereas LOS for admitted patients increased from 405 to 441 minutes (difference of +36; 95% CI, 26-46). After controlling for covariates, CPOE implementation was associated with a 23-minute decrease in LOS for discharged patients (β = -23 [95% CI, -26 to -19]).

Conclusion: Implementation of CPOE was associated with a clinically significant (23-minute) decrease in LOS among patients who were discharged from the ED.