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Environmental impact and satisfaction associated with ENT ePrescriptions: A quality improvement study
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  • Abiram Chandiramohan,
  • Sarah Zahabi,
  • Leigh J. Sowerby,
  • * Peng,
  • Jacob Davidson,
  • Celia Dann,
  • Julie E. Strychowsky
Abiram Chandiramohan
Western University Schulich School of Medicine & Dentistry
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Sarah Zahabi
Western University Department of Medicine
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Leigh J. Sowerby
Western University Schulich School of Medicine & Dentistry
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* Peng
Western University Department of Medicine
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Jacob Davidson
Western University Department of Medicine
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Celia Dann
Western University Department of Medicine
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Julie E. Strychowsky
Western University Schulich School of Medicine & Dentistry

Corresponding Author:[email protected]

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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.