Published in the February 2015 issue of Today’s Hospitalist
Blown off: medication warnings
HOW OFTEN do clinicians pay attention to medication warnings generated by CPOE? Rarely, according to a new study published online last month by the Journal of Hospital Medicine.
The research took place in one academic center. Over seven months, the center’s electronic ordering system generated more than 40,000 medication warnings, of which only 4% were accepted. Among warnings, 47% were duplicates, 47% were interaction warnings, 6% were about allergies, 0.1% were adverse reaction warnings, and 9.8% were repeated warnings for the same patient, provider and medication. (Some of the warnings met more than one criterion.)
The authors found that internal medicine residents were particularly adept at overriding warnings. Warnings were more likely to be overridden when patients were older and when orders were for drugs on the ISMP’s list of high-alert medications.
The study concludes that, “Warning systems should be redesigned to increase their effectiveness for the sickest patients, the least experienced physicians, and the medications with the greatest potential to cause harm.”
Fierce competition for new physicians
RESIDENTS leaving training in 2014 were inundated with job offers, with more than 40% reporting that they received 100 or more contacts from recruiters.
That’s according to the latest Merritt Hawkins survey, which was released last month, on final-year medical residents. Based on e-mail responses from more than 1,200 residents, survey results indicate that 36% of final-year residents wanted to be employed by a hospital and that “free time” was their biggest concern. Only 3% wished to practice in communities of 25,000 or less, and the majority (56%) received no formal training in contracts, compensation packages, coding or reimbursement.
The vast majority (92%) wanted to be employed with a salary or a salary with a production bonus, not an income guarantee. While 25% owed nothing in terms of student loans, 57% owed at least $100,000 and 35% owed $200,000 or more.
And although 75% claimed they were happy with their choice of medicine as a career, 25% noted that given the opportunity, they would choose another field.