National trends in safety performance of electronic health record systems in children's hospitals.

Autor:	Chaparro JD; Departments of Biomedical Informatics and Pediatrics, University of California San Diego, and Rady Children's Hospital, San Diego, California, USA., Classen DC; University of Utah School of Medicine, Salt Lake City, Utah, USA., Danforth M; The Leapfrog Group, Washington, DC, USA., Stockwell DC; Children's National Health System and George Washington University School of Medicine, Washington, DC, USA., Longhurst CA; Departments of Biomedical Informatics and Pediatrics, University of California, San Diego, USA.
Jazyk:	angličtina
Zdroj:	Journal of the American Medical Informatics Association : JAMIA [J Am Med Inform Assoc] 2017 Mar 01; Vol. 24 (2), pp. 268-274.
DOI:	10.1093/jamia/ocw134
Abstrakt:	Objective: To evaluate the safety of computerized physician order entry (CPOE) and associated clinical decision support (CDS) systems in electronic health record (EHR) systems at pediatric inpatient facilities in the US using the Leapfrog Group's pediatric CPOE evaluation tool. Methods: The Leapfrog pediatric CPOE evaluation tool, a previously validated tool to assess the ability of a CPOE system to identify orders that could potentially lead to patient harm, was used to evaluate 41 pediatric hospitals over a 2-year period. Evaluation of the last available test for each institution was performed, assessing performance overall as well as by decision support category (eg, drug-drug, dosing limits). Longitudinal analysis of test performance was also carried out to assess the impact of testing and the overall trend of CPOE performance in pediatric hospitals. Results: Pediatric CPOE systems were able to identify 62% of potential medication errors in the test scenarios, but ranged widely from 23-91% in the institutions tested. The highest scoring categories included drug-allergy interactions, dosing limits (both daily and cumulative), and inappropriate routes of administration. We found that hospitals with longer periods since their CPOE implementation did not have better scores upon initial testing, but after initial testing there was a consistent improvement in testing scores of 4 percentage points per year. Conclusions: Pediatric computerized physician order entry (CPOE) systems on average are able to intercept a majority of potential medication errors, but vary widely among implementations. Prospective and repeated testing using the Leapfrog Group's evaluation tool is associated with improved ability to intercept potential medication errors. (© The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com)
Databáze:	MEDLINE
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