Leapfrog Group Finds Hospitals Implementing Safety Systems but Not Fully Utilizing

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Hospital Peer Review

April 22, 2019

A majority of hospitals are meeting the standards for computerized physician order entry (CPOE) set by The Leapfrog Group, based in Washington, DC, according to a recent report from the group.

Sixty-five percent of hospitals in the survey met the Leapfrog CPOE standards, says Erica Mobley, director of operations with The Leapfrog Group.

The Leapfrog Group’s 2019 Medication Safety Report found that “Hospitals that fully met Leapfrog’s CPOE standard are more likely to be teaching than nonteaching (72% vs 62%) and more likely to be urban than rural (68% vs. 47%).” In addition, “Slightly less than half of all types of hospitals—urban, rural, teaching, and nonteaching—fully met Leapfrog’s Bar Code Medication Administration standard.”

The report looked at two measures for what hospitals are doing to prevent medication errors in CPOE. There is no good outcome measure for how frequently medication errors happen in a hospital, Mobley says, so the Leapfrog survey looks at the process measures.

“We ask hospitals to participate in a simulation test to see how well the CPOE is working. The tool asks hospitals to input a set of dummy patients into their CPOE system, and then we give them a set of orders for those patients and we’re looking to see if that CPOE system is putting off the correct alerts for those patients,” Mobley explains. “If we put a pediatric patient in the system and then try to prescribe an adult dosage to that patient, we want to be sure their system is putting off an alert that this is probably the wrong dosage and urging the user to double-check before it goes to the pharmacy. Most hospitals spend millions of dollars implementing these systems, and this is the only way we know of to see if they are working as they should.”

About two-thirds of hospitals are entering at least 85% of inpatient orders through a CPOE system, and about 70% of the systems provide the proper alerts to potential medication errors, Mobley says.

“Those are good figures, but that still means there is a substantial number of hospitals not receiving the proper alerts,” Mobley says. “There is a lot of customization that occurs with these systems, and this is a way to see if the system is working as it should or if more adjustments are needed.”

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