Acute care hospitals in California are combating some of the most common and harmful medical errors by leveraging the power of electronic health records, according to a new staff report released by U.S. Senator Barbara Boxer (D-Calif.).
In a survey conducted by her office, Boxer wrote to 283 California hospitals asking them what steps they are taking to reduce medical errors, of which nearly 53 percent--149 hospitals--responded to the query, many of whom noted the benefits of EHRs at their facilities.
One of the most common type of medical errors are preventable adverse drug events which affect nearly 5 percent of hospitalized patients. However, using barcode technologies and EHRs with computerized prescriber order entry, hospitals are able to eliminate errors due to illegible hand-writing and through the standardization of medications and dosages. In addition, pharmacists are actively involved throughout a patients hospitalization, from reviewing the medications a patient is on at admission to reviewing a patients EHR for prescribing errors.
Another common medical error cited by the Boxer report involves central line-associated blood stream infections in which a catheter is placed into a large vein in the neck, chest, or groin. These infections are usually serious infections typically causing a prolonged hospital stay and increased cost and risk of mortality.
To address this serious problem, UC San Diego Health System built a tool within their EHR system for documenting Central Line Insertion Practice (CLIP) bundle performance at the time central line insertions are placed in inpatient care sites as well as emergency departments. The EHR tool "prompts providers to comply with required bundle elements and facilitates accurate data abstraction, according to the report.
Venous thromboembolism, a condition that includes both deep vein thrombosis and pulmonary embolism, is the most common preventable cause of hospital death. California hospitals surveyed by Boxer's office indicated that a common approach to this problem is having the EHR prompt the clinician to order deep-vein thrombosis prevention (mechanical intervention or pharmaceutical intervention) or to document the reasons why it was not ordered.
When it comes to policy considerations, Boxer's report recommends that in the next round of EHR regulations the Office of the National Coordinator for Health IT should include a standard way of reporting medical errors, specifically the common formats developed by the Agency for Healthcare Research and Quality for reporting patient safety events to Patient Safety Organizations. "This will allow hospitals and researchers to better collect data on errors, their frequency, and where they are occurring," concludes the report.
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