Environmental impact and satisfaction associated with ENT
ePrescriptions: A quality improvement study
Abstract
Objective: ePrescriptions are associated with increased patient
satisfaction, decreased provider burden, decreased administrative costs,
and a positive impact on planetary health. We aimed to attain 20%
overall usage of ePrescriptions in the Department of Otolaryngology-Head
and Neck Surgery (OHNS) at the London Health Sciences Centre (LHSC) by
December 2023. Method: This project followed the Institute for
Healthcare Improvement model and used a pre-post intervention design. A
root-cause analysis identified potential obstacles to ePrescribing.
Change ideas, including educational seminars, surveys, quarterly
reporting of ePrescription usage, and public encouragement of top
ePrescribers in the department, were implemented and tested using
Plan-Do-Study-Act cycles. ePrescription usage and carbon footprint
savings associated with ePrescriptions were measured. Provider and
patient satisfaction surveys were conducted as balancing measures for
perception of increased burden on providers. Results: During
the pre-intervention and post-intervention phases, a total of 400 and
1000 ePrescriptions were prescribed by the department, respectively.
There was a statistically significant increase in the mean proportion of
ePrescription used before (mean: 9.7%; sd=7.6) and after (mean: 40.7%;
sd=6.4) the intervention (p<0.001), which exceeded the goal. SPC
charting suggested special cause variation, signifying a statistically
significant improvement. Additionally, a reduction of 125.9 lbs of CO
2 equivalents was associated with ePrescription use.
66.7% of providers rated overall satisfaction with ePrescriptions at
7/10 or higher, and 76.9% indicated that patients either sometimes,
usually, or always opted for ePrescriptions when given the choice.
Conclusion: Our change ideas increased ePrescription usage in
an academic OHNS department and was associated with increased planetary
health savings and provider satisfaction.