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An exploratory study measuring verbal order content and context
  1. D S Wakefield1,
  2. J Brokel2,
  3. M M Ward3,
  4. T Schwichtenberg4,
  5. D Groath4,
  6. M Kolb5,
  7. J W Davis6,
  8. D Crandall7
  1. 1
    University of Missouri Center for Health Care Quality, Department of Health Management and Informatics, Columbia, Missouri, USA
  2. 2
    University of Iowa College of Nursing, Iowa City, Iowa, USA
  3. 3
    University of Iowa Department of Health Management and Policy, Iowa City, Iowa, USA
  4. 4
    Mercy Medical Center of North Iowa, Mason City, Iowa, USA
  5. 5
    University of Missouri Center for Health Care Quality, Columbia, Missouri, USA
  6. 6
    University of Missouri Department of Health Management and Informatics, Columbia, Missouri, USA
  7. 7
    Trinity Health, Novi, Michigan, USA
  1. Dr D S Wakefield, Center for Health Care Quality (CHCQ), MA120 Medical Sciences Bld., DC375.00, One Hospital Drive, University of Missouri, Columbia, MO 65212, USA; wakefielddo{at}


Background: The use of verbal orders, while essential in some healthcare settings, has been identified as a potential contributor to poor quality and less safe care. Despite the widespread use of verbal orders, little research attention has been paid to understanding and measuring the content of verbal orders or variables related to the context in which verbal orders are made.

Aim: This paper first identifies variables related to verbal order content and context, and then provides detailed analyses from two exploratory studies conducted in one community hospital.

Methods: The data presented were collected using both a paper-based manual audit, and an analysis of data generated from a computerised order entry system.

Discussion: Selected analyses focus of variations in types and timing of verbal orders hospital-wide as well as for specific inpatient units, changes in verbal order utilisation following implementation of a computerised provider order entry system, and an analysis of the presence of sound-alike and high-alert medications in verbal orders.

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  • See Commentary, p 164

  • Additional tables are published online only at

  • Funding: This work is supported by funding from AHRQ-THQIT Implementation #1 UC1HS015196 and the University of Missouri Center for Health Care Quality.

  • Competing interests: None.

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