Benchmarking: A Case Study

During the 1980’s and 90’s there were many studies done that showed that medical errors were occurring in inpatient and outpatient settings at a very high rate. Computer Provider Order Entry (CPOE) systems were designed to reduce or eliminate mistakes made by using hand written orders. The CPOE system allows users to directly enter their orders into the system on computers which are then sent directly to the healthcare providers that will be implementing the orders. Previously orders were placed by writing on order sheets on patient charts. This was sometimes done by the doctor or by a nurse acting on behalf of the doctor. Order sheets were then signed by the doctor and then the information was input into the patient’s record. This left

CPOE systems have been proven to decrease medication errors and promote patient safety effectively. A study (Patent Safety Primer, 2014) suggested that 90% of medication errors occurred during the ordering or transcribing stages, and a systematic literature review shows that CPOE was able to reduce those errors by 48% compared to paper-based orders ( Radley, Wasserman & Bradshaw, et al. 2013). CPOE systems are effective in reducing medication errors by eliminating problems related to hand writing,

The stage 1 of the meaningful use includes thirteen core criteria and ten menu set objectives. The first core criteria is the computerized provider order entry (CPOE). CPOE entails the provider’s use of computer assistance to directly enter medication orders from a computer or mobile device. The use of CPOE and the electronic prescription process is a technology that has been found to be helpful in preventing medication prescribing errors in several ways (Mominah & Househ, 2013). Having an accurate electronic patient medication profile will help prescribers and pharmacists review the medication history easily and consequently alert the pharmacist to communicate with the prescriber in case any unexplained change in the prescribed medication to the patient and then conforming the change with the prescriber. Applying CPOE technology reduces medication errors.

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

In addition to the core objectives, eligible professionals must also meet 5 out of 10 from the menu set of objectives. The lists of menu objectives are as follows.

Computerized Physician Order Entry (CPOE) is a complex technology mandated by Centers for Medicare Services (CMS) in Meaningful Use criteria for adoption by healthcare providers (Self & Coffin, 2016). CPOE is technology for reduction in medication errors through implementation of standardization of processes to support legibility and reduction in the number of people required to participate in the order workflow, thus decreased delays and errors result due to miscommunication (Hoonakker et al., 2013). Although CPOE highlights improvement in quality and safety, healthcare organizations have expressed difficulty in the implementation due to physician resistance (Hoonakker et al, 2013). This resistance not only contributes to patient safety

This communication is to inform our fellow team member and most especially the physician groups about the intention of the organization to implement the Computerized Physician Order Entry (CPOE) system. The CPOE application will enable our physician provider to enter order directly into the computer system, the CPOE system will replace the old method of order entry that include, written, verbal order/telephone order, and fax. The CPOE system will enable physician to enter specifications about order such as, laboratory, medication, radiology and special procedure orders. Additionally, CPOE offers some the features of the Clinical Decision Support (CDS) at the point of order entry by recommendation dosage calculations, interactions with other medications, and warning of allergic reaction notifications with alternate medication

Decreasing healthcare “cost” has been repeatedly debated for decades now. Despite tremendous efforts to reduce cost, the US Healthcare System is still struggling to deliver an effective and affordable level of care. Not only the cost of healthcare is higher in the U.S., there is also much waste due to unnecessary laboratory, radiology & other investigations, unwanted hospitalizations, procedures, longer hospital stay, preventable emergency room visits, and a lot of medications waste, that costs the U.S. $750 billion annually according to IOM in 2012 (Glicksman E. , 2015).

Charles, K., Cannon, M., Hall, R., & Coustasse, A. (2014, October 1). Can utilizing a computerized provider order entry (CPOE) system prevent hospital medical errors and adverse drug events? Perspectives in Health Information Management, 11(Fall): 1b Retrieved from http://perspectives.ahima.org/can-utilizing-a-computerized-provider-order-entry-cpoe-system-prevent-hospital-medical-errors-and-adverse-drug-events/#.Vpg-Q_krLIU

Computerize provider order entry has had a tremendous impact on improving patient safety and health care outcomes. As a post-operative unit secretary, I often had the wonderful task of transcribing physician orders. I spent more time trying to contact the physician’s to ensure that I understood their handwriting then actually transcribing the order. There were numerous medication errors made through the assumption of transcribed orders. Consequently, computerized provider order entry helped to significantly reduce those risks. However, I have witness computerized provider order entry errors made by clinicians that the system fails to recognize. For example, a patient reported taking an anxiety medication X 2.5mg PO daily upon admission. Four

The use and advancement of technology has expanded throughout the years. Technology has recently begun to be incorporated into the healthcare setting to enhance patient care, patient safety, and to optimize therapeutic outcomes. This concept is otherwise known as medical informatics, and is composed of six core areas: electronic health records (EHR), computerized provider order entry (CPOE), electronic prescribing, pharmacy automation and dispensing systems, privacy and security of informatics, and telehealth. Computerized provider order entry specifically refers to a licensed healthcare professional inputting medication orders and other medical information into an electronic pharmaceutical program.1 However, implementing CPOE has revealed

b) Large variation exist in the per capita healthcare expenditure across the United States which can be attributed to difference in healthcare services provided due to absence of evidence based treatment. c) Overuse and misuse of healthcare services are proving to be costly, pervasive and causing harm to the patients.

Health care costs in the United States continue to be on a raise as money is been wasted unnecessarily in all areas of health care. Wasteful spending in health care has many undesirable consequences that could be alleviated through waste reduction. Implementing waste-reduction strategies, and reducing the burden of unnecessary health care spending is one area that should be considered today (Bentley, T. G., Effros, R. M., Palar, K., & Keeler, E. B.,2008). Waste in health care is defined as healthcare services that do not add value or improve patient outcomes, where at the same time healthcare professionals are ethically obligated to provide the best care possible to individual patients and their families (Medicare Waste in Unnecessary Admissions,

A health care facility that is generating the resources needed to meet its mission is financially important to its success. Economic resources are one component that contributes to a firm’s success. Factors used in producing goods or providing services that are used to create things or help you provide services. Economic resources can be divided into human resources,

Benchmarking is a powerful tool used to promote continuous improvement of an organization. It enables the decision-makers to realize how much improvement is required to achieve satisfactory performance. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has defined benchmarking as “a measurement tool for monitoring the impact of governance, management and clinical and logistical functions” (as cited in Ettorchi-Tardy, Levif & Michel, 2012). There are four different kinds of benchmarking: internal, external or competitive, functional and generic or best practice. Also, there are several benefits of using benchmarking within healthcare organizations such as improving the quality of patient care, encouraging accountability among providers, improving productivity, yielding greater efficiency, meeting accreditation requirements, etc.