J Am Med Inform Assoc - Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool.

Tópicos

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Resumo

JECTIVE: The Leapfrog CPOE evaluation tool has been promoted as a means of monitoring computerized physician order entry (CPOE). We sought to determine the relationship between Leapfrog scores and the rates of preventable adverse drug events (ADE) and potential ADE.MATERIALS AND METHODS: A cross-sectional study of 1000 adult admissions in five community hospitals from October 1, 2008 to September 30, 2010 was performed. Observed rates of preventable ADE and potential ADE were compared with scores reported by the Leapfrog CPOE evaluation tool. The primary outcome was the rate of preventable ADE and the secondary outcome was the composite rate of preventable ADE and potential ADE.RESULTS: Leapfrog performance scores were highly related to the primary outcome. A 43% relative reduction in the rate of preventable ADE was predicted for every 5% increase in Leapfrog scores (rate ratio 0.57; 95% CI 0.37 to 0.88). In absolute terms, four fewer preventable ADE per 100 admissions were predicted for every 5% increase in overall Leapfrog scores (rate difference -4.2; 95% CI -7.4 to -1.1). A statistically significant relationship between Leapfrog scores and the secondary outcome, however, was not detected.DISCUSSION: Our findings support the use of the Leapfrog tool as a means of evaluating and monitoring CPOE performance after implementation, as addressed by current certification standards.CONCLUSIONS: Scores from the Leapfrog CPOE evaluation tool closely relate to actual rates of preventable ADE. Leapfrog testing may alert providers to potential vulnerabilities and highlight areas for further improvement.

Resumo Limpo

jectiv leapfrog cpoe evalu tool promot mean monitor computer physician order entri cpoe sought determin relationship leapfrog score rate prevent advers drug event ade potenti ademateri method crosssect studi adult admiss five communiti hospit octob septemb perform observ rate prevent ade potenti ade compar score report leapfrog cpoe evalu tool primari outcom rate prevent ade secondari outcom composit rate prevent ade potenti aderesult leapfrog perform score high relat primari outcom relat reduct rate prevent ade predict everi increas leapfrog score rate ratio ci absolut term four fewer prevent ade per admiss predict everi increas overal leapfrog score rate differ ci statist signific relationship leapfrog score secondari outcom howev detecteddiscuss find support use leapfrog tool mean evalu monitor cpoe perform implement address current certif standardsconclus score leapfrog cpoe evalu tool close relat actual rate prevent ade leapfrog test may alert provid potenti vulner highlight area improv

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