ABSTRACT
The system checked laboratory and medication orders against diagnoses in one specialty area, matched those diagnoses with symptoms for conditions, and also issued alerts when various data indicated abnormalities. The new system, the administration was convinced, was improving quality. A local computer scientist had produced the system in close consultation with clinical and quality assurance staff. All clinicians were trained to use the system, as were residents when they began their rotations at this hospital. Clinicians saw the system as the administration’s reporting tool, whereas the administration described the system as benefiting clinicians and improving clinical care. Further, the clinical staff felt pressured, recently having gone through a merger with a nearby larger hospital and having to adjust to new ways of doing things.
