Healthcare News & Insights

Tech & medication errors: Are hospitals meeting guidelines?

Reducing medication errors is an ongoing battle for hospitals, and technology is the latest weapon they’re using to fight it. A new report from the Leapfrog Group highlights what many hospitals are doing to keep patients from being harmed due to issues with the medications they’re taking. 

According to the report, most hospitals are currently using technology to keep providers from prescribing drugs that could harm patients. Two types of technology are critical to preventing medication errors: bar code medication administration (BCMA) and computerized physician order entry (CPOE).

CPOE is common in hospitals due to the widespread use of electronic health records (EHR) systems. BCMA technology uses scanners and bar codes to ensure patients are receiving the right medications. While many hospitals are using the two technologies together, few are meeting the Leapfrog Group’s standards for both.

To meet the mark for CPOE, hospitals must:

  • order at least 75% of inpatient medication orders through a CPOE system with decision-support software that’s linked to the facility’s EHR or hospital information system, and
  • show that the CPOE system alerts doctors to at least half of the most common, serious errors involving prescription medications (pediatric facilities are exempt).

And for BCMA, facilities must meet four additional standards:

  1. Implement a BCMA system that’s linked to an electronic medication administration record in all the hospital’s medical/surgical units (pediatric, adult) and intensive care units (neonatal, pediatric, adult).
  2. Scan patient and medication barcodes in 95% of bedside medication administrations in each unit where the system’s been implemented.
  3. Make sure the system includes a way to automatically check for all seven of the Leapfrog Group’s decision-support elements to prevent medication administration errors (wrong dose, wrong medication, wrong time, wrong patient, patient-specific allergy check, second nurse check and vital-sign check).
  4. Implement the five best practices to ensure the BCMA system is constantly up and running at peak efficiency (creating a committee to review BCMA use, creating a help desk specifically to address BCMA issues, having a backup system for hardware failures, observing users of the BCMA system and engaging nurse leaders).

How hospitals measure up

When considering CPOE on its own, hospitals have made significant strides in meeting Leapfrog’s standards. Currently, 74% of facilities have a system that passes the test, which is 10% higher than where hospitals stood last year. It’s also more than double the amount of hospitals that met these guidelines in 2012.

More work needs to be done with BCMA technology, however. Only 30% of hospitals met all four of Leapfrog’s criteria, and 35% met three out of four standards. A little over a quarter (26%) measured up with half of the criteria, while 9% met either none or one of the standards.

Facilities had the most problems with integrating the seven decision-making elements into their BCMA systems and using the scanning technology for at least 95% of beside medication administrations.

Hospitals with both CPOE and BCMA had even more issues to tackle with each system. Those using both technologies to prevent medication errors only met all the standards 22% of the time.

Next steps

To use each of these technologies to their full potential, facilities must constantly evaluate and review their performance with preventing medication errors, using any issues as opportunities for improvement.

Hospitals must also work to fill any gaps that keep them from meeting the Leapfrog Group’s standards, working closely with their vendors to implement additional features or upgrades that may help their systems be more efficient at catching potential errors.

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