Impact of computerized physician order entry on ED patient length of stay

ObjectivesWe evaluated whether implementation of computerized physician order entry (CPOE) reduces length of stay (LOS) for discharged emergency department (ED) patients.MethodsEmergency department LOS for discharged and admitted patients were analyzed in a university-affiliated ED before and after introduction of CPOE. Patient demographics and covariates that may affect LOS (mode of arrival, provider staffing, daily census, and admission rate) were measured.ResultsThe study included 71 188 patients; 49 175 (69%) were discharged from the ED (28 687 before and 20 488 after CPOE). Length of stay for discharged patients decreased from 198 to 168 minutes (difference of −30; 95% confidence interval [CI], −28 to −33), whereas LOS for admitted patients increased from 405 to 441 minutes (difference of +36; 95% CI, 26-46). After controlling for covariates, CPOE implementation was associated with a 23-minute decrease in LOS for discharged patients (β = −23 [95% CI, −26 to −19]).ConclusionImplementation of CPOE was associated with a clinically significant (23-minute) decrease in LOS among patients who were discharged from the ED.