A comparison of the impact of CPOE implementation and organizational determinants on doctor-nurse communications and cooperation

Objective: To compare the impact of CPOE implementation and of the workplace organizational determinants on the doctor-nurse cooperation and communication processes. Method: A first study was undertaken in eight different wards aimed to identify the different workplace organizations that support doctor-nurse communications'. A second study compared the impact of these organizations and of a CPOE on medication-related doctor-nurse communications. Results: The doctor-nurse communications could be structured into three typical workplace organizations: the common round, the briefing and the opportunistic exchange organizations. The results (i) confirmed the impact of the organizational determinants on the cooperative activities and (ii) demonstrated the CPOE system has no significant impact within a given workplace organization. Conclusion: The success of the implementation of HIT applications relies partly on the identification of the actual (and sometimes hidden) structuring variables of teamwork and ultimately on their control at the time of implementation to ensure the quality and safety of the patient care provided.