A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital

• HIT Description: Computerized decision support with alerts. More info...
  
• Purpose of Study: Assess a computer alert system designed to correct errors that might lead to adverse drug events (ADEs) and to detect ADEs before maximum injury occurs.
  
• Years of study: 1997-1998
  
• Study Design: Cross-sectional
  
• Outcomes: Impact on patient safety
  

• Settings: The study was conducted at a 650-bed community teaching hospital in Phoenix, Arizona with 9306 nonobstetrical adult patients admitted during the last 6 months of 1997.
• Intervention: The hospital information system was programmed to generate alerts in clinical situations with increased risk for ADE-related injury, and a clinical system was developed to ensure physician notification of alerts.
• Evaluation Method: Measures of true-positive alerts, and injury prevention.
• Quality of Care and Patient Safety Outcome: The alert system fired 1116 times and 596 were true-positive alerts (positive predictive value of 53%). The alerts identified opportunities to prevent patient injury secondary to ADEs at a rate of 64 per 1000 admissions. A total of 265 (44%) of the 596 true-positive alerts were unrecognized by the physician prior to alert notification.