Project Details - Ended
- Grant Number:R21 HS023704
- Funding Mechanism:
- AHRQ Funded Amount:$293,130
- Principal Investigator:
- Project Dates:9/30/2014 to 9/29/2018
- Care Setting:
- Type of Care:
- Health Care Theme:
Computerized provider order entry (CPOE) systems have been shown to prevent many types of medical errors, but certain types of errors occur frequently in these systems, including placing orders on the wrong patient. While provider efficiency may be increased by allowing multiple records to be open at once, this configuration has the potential to increase the risk of wrong patient errors when providers mistakenly choose the wrong patient record to place orders. Decisions need to be made regarding how many patient records will be allowed to be open at one time; however, there is no existing research to inform these decisions. This study will provide data on the risk of wrong patient errors when varying numbers of records are open at once, helping to inform decisionmakers on the optimal configuration of their CPOE systems.
The specific aims of the project are as follows:
- Assess the relationship between the number of records open at the time of placing an order, and the risk of placing an order on the wrong patient in a prospective, observational study
- Compare the incidence of wrong-patient orders in a “restricted environment” that limits its providers to only one record open at a time to an “unrestricted environment” where users can open a maximum of four records at once in a randomized controlled trial
Each aim will be carried out at a separate study site to prevent the randomized controlled trial from confounding the prospective, observational study. The prospective, observational study will be conducted at Brigham and Women’s hospital in Boston, MA, and the randomized controlled trial will be conducted at Montefiore Medical Center in the Bronx, NY. Each organization uses the same electronic medical record system. The prospective, observational study will examine the relationship between the number of records open at the time of placing an order and the risk of placing an order on the wrong patient. The randomized controlled trial will evaluate the wrong patient error rate when the system is configured to allow only one record open at a time, compared to when the system is configured to allow a maximum of four records open at a time.