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121. USA, MS, Jackson | Digital Healthcare Research
     digital.ahrq.gov/location/usa-ms-jackson
     January 01, 2023 - ability of EHRs to facilitate patient outcomes tracking, improve provider communication, reduce medical errors … Principal Investigator(s) Matthews, Karen Detecting Med (Medication) Errors … Technology Description Implemented and evaluated a voluntary system for reporting medical errors … rural hospitals; identified barriers to technology, described the epidemiology and root causes of the errors

122. A Prototype Computerized Provider Order Entry System Reduced Medication Errors | Digital Healthcare Research
     digital.ahrq.gov/2018-year-review/research-spotlights/prototype-computerized-provider-order-entry-system-reduced
     January 01, 2018 - A Prototype Computerized Provider Order Entry System Reduced Medication Errors Key Finding and … Mistakes made by patients and providers can lead to medication errors. … Medication errors may also occur during the prescribing process, including prescribing the wrong medication … Including medical indications in the prescribing process can reduce medication errors. … Specifying the indication during the prescribing process can help avoid medication errors; however, the

123. Blackbox: A Multidisciplinary Team-Based Framework for HIT Error Pattern Detection - Final Report (pdf file)
     digital.ahrq.gov/sites/default/files/docs/citation/r21hs024755-hettinger-final-report-2019.pdf
     January 01, 2019 - to determine why these errors occur and how to make informed changes to improve the EHR. … for approximately 34 errors. … Potential solutions for these errors include 1. … quickly and easily EHR errors can occur. … Role of computerized physician order entry systems in facilitating medication errors.

124. Detecting Med (Medication) Errors in Rural Hospitals Using Technology - 2008 | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/detecting-med-medication-errors-rural-hospitals-using-technology/annual-summary/2008
     January 01, 2008 - Detecting Med (Medication) Errors in Rural Hospitals Using Technology - 2008 Project … Name Detecting Med (Medication) Errors in Rural Hospitals Using Technology Principal Investigator … ) and continuing medical education (CME) credits focusing on the importance of reporting medication errors … Data were collected from this date until August 31, 2008; in total, 805 errors were documented. … demonstrate, and evaluate strategies in partnership with the participating institutions for reducing errors

125. Tools for Optimizing Medication Safety (TOP-MEDS) | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/tools-optimizing-medication-safety-top-meds
     January 01, 2023 - Pharmacist Type of Care Primary Care Health Care Theme Medication Errors … system has ongoing problems of underuse, overuse, and misuse of medications, leading to medication errors … Automated detection of wrong-drug prescribing errors. … Learning from errors: analysis of medication order voiding in CPOE systems. … Automated detection of look-alike/sound-alike medication errors.

126. The effect of computerized physician order entry on medication errors and adverse drug events in pediatric inpatients | AHRQ Digital Healthcare Research: Informing Improvement in Care Quality, Safety, and Efficiency
     digital.ahrq.gov/health-it-tools-and-resources/health-it-costs-and-benefits-database/effect-computerized-physician-0
     September 01, 2003 - The effect of computerized physician order entry on medication errors and adverse drug events in pediatric … of Study:  Evaluate the impact of a computerized physician order entry (CPOE) system on medication errors … Evaluation Method:  Measures of medication errors and adverse drug events. … Quality of Care and Patient Safety Outcome:  In 6 years, a total of 804 medication errors were identified

127. Bar Coding for Patient Safety in Northern Michigan | Digital Healthcare Research
     digital.ahrq.gov/ahrq-funded-projects/bar-coding-patient-safety-northern-michigan
     January 01, 2023 - Type of Care Acute Care Health Care Theme Adverse Events Medication Errors … Goals and initiatives at all hospitals were focused on reducing Adverse Drug Events and medication errors … These events and errors occur at several places along the medication chain, including ordering medication … Plans have been completed to address errors at the dispensing, ordering and transcribing phases through … It tracks "near misses," so that more errors can be avoided in the future.

128. A National Web Conference on Improving Health IT Safety Through the Use of Natural Language Processing to Improve Accuracy of EHR Documentation - Slides (pdf file)
     digital.ahrq.gov/sites/default/files/docs/improving-hit-safety-slides-020717.pdf
     February 07, 2017 - • ~5 million errors per year are tied to wrong medications; 1 in 4 medication errors involves a … ; 1.3 errors per note; 9 errors per 1000 words … ; % = number of errors of a specific type divided by the total number of errors 58 Clinical … Across Note Stages Total Errors Clinical Information Errors n (%) General English … Figure Errors by Semantic Type. Clinical Informat ion Errors in SR Notes. .

129. Assessment of Pediatric Look-Alike, Sound-Alike (LASA) Substitution Errors - Final Report (pdf file)
     digital.ahrq.gov/sites/default/files/docs/publication/r03hs018841-basco-final-report-2013.pdf
     January 01, 2013 - LASA errors in ambulatory pediatric practice. … they might occur much less often than doing errors. … would be a preferred approach to reducing these errors. … and frequency of these errors will be needed in order to implement screening for those LASA pair errors … the potential errors is in progress.

130. The impact of computerized physician order entry on medication error prevention | AHRQ Digital Healthcare Research: Informing Improvement in Care Quality, Safety, and Efficiency
     digital.ahrq.gov/health-it-tools-and-resources/health-it-costs-and-benefits-database/impact-computerized-physician-0
     May 01, 1993 - Evaluation Method:  Measure of medication errors, excluding missed dose errors. … Non-intercepted serious medication errors (those with the potential to cause injury) fell 86 percent … Large differences were seen for all main types of medication errors: dose errors, frequency errors, route … errors, substitution errors, and allergies. … For example, in the baseline period there were ten allergy errors, but only two in the following three

131. Medication Without Harm: How Digital Healthcare Tools Can Support Providers and Improve Patient Safety (pdf file)
     digital.ahrq.gov/sites/default/files/docs/medication-without-harm-slides-07242024.pdf
     January 12, 2025 - as the Wrong-Patient Retract-and-Reorder measure, can be developed and used to detect medication errors … medication discontinuation to pharmacies, we can improve patient safety by reducing medication errors … Technical errors 4. Memory-based (lapses) Aronson JK, Ferner RE. … • The first RAR measure identified wrong-patient errors. … New RAR measures identify wrong dose, wrong frequency, and wrong route medication errors.

132. National Teleconference February 2011 (pdf file)
     digital.ahrq.gov/sites/default/files/docs/better-medication-management-slides-021611.pdf
     February 16, 2011 - Preventing Medication Errors: Quality Chasm Series. … Adverse drug events causes by medication errors in medical inpatients. … Dispensing errors and counseling quality in 100 pharmacies. … Severity score Medication Ordering to Reduce Errors Prevention of Medication Errors … – Vulnerable to data entry errors, wrong patient errors • Second verification process reduced risk

133. How Capable of Using Information Technology is the Average Patient? (pdf file)
     digital.ahrq.gov/sites/default/files/docs/page/2006FriedmanSantinonFormica_052411comp.pdf
     May 26, 2011 - MD Yale University School of Medicine Why should surgeons care about medication errors? … Yale New Haven Organ Transplant Center • 219 post-transplant visits • 15 visits with errors (6.8%) … • 5 visits with adverse events (2.2%) • 29 errors; 1.9 errors per visit, range (0-7) Medication errors … results from causes in the healthcare system Patients are the cause of 66% of errors Prevention of errors … Why should surgeons care about medication errors?

134. Administrative System | Digital Healthcare Research
     digital.ahrq.gov/technology/administrative-system
     January 01, 2023 - emergency medical service settings and emergency departments; also evaluated its impact on reducing errors … Principal Investigator(s) Brustrom, Jennifer Detecting Med (Medication) Errors … Technology Description Implemented and evaluated a voluntary system for reporting medical errors … rural hospitals; identified barriers to technology, described the epidemiology and root causes of the errors … The goals of the project were to reduce medical errors, improve the quality of patient care, increase

135. Medication Safety | Digital Healthcare Research
     digital.ahrq.gov/health-care-theme/medication-safety
     January 01, 2023 - Investigator(s) Hettinger, Aaron Zachary An Etiology for Medication Ordering Errors … Order Entry Systems Description This research assessed the etiology of medication ordering errors … , finding that errors stemmed from multi-level risk factors and showing the utility of a void alert tool … to prospectively capture the broad range of errors that may occur in practice that may be missed by … can be readily integrated into electronic health records to study the epidemiology of order errors and

136. Section 8 - A Peek at the Literature on Medication Use and CDS | AHRQ Digital Healthcare Research: Informing Improvement in Care Quality, Safety, and Efficiency
     digital.ahrq.gov/ahrq-funded-projects/current-health-it-priorities/clinical-decision-support-cds/chapter-1-approaching-clinical-decision/section-8-peek-literature-medication-use-and-cds
     January 01, 2006 - safety entitled Preventing Medication Errors, as part of their Quality Chasm series …   [24]    The report looked at both prescribing and administration errors. … Prescribing error rates ranged from 12.3 to 1,400 errors per 1,000 admissions. … and estimated approximately 0.3 errors per patient per day … Administration errors also occur with significant frequency.

137. University of Texas Health Science Center - Houston | Digital Healthcare Research
     digital.ahrq.gov/organization/university-texas-health-science-center-houston
     January 01, 2023 - Monitoring Using Electronic Records to Detect and Learn from Ambulatory Diagnostic Errors … Eric Project Name Using Electronic Records to Detect and Learn from Ambulatory Diagnostic Errors … Eric Using Electronic Records to Detect and Learn from Ambulatory Diagnostic Errors … record-based trigger methods can enable more meaningful measurement and surveillance of diagnostic errors

138. Editorial | Digital Healthcare Research
     digital.ahrq.gov/document-type/editorial
     January 01, 2024 - Patient Outcomes Beyond mixed case lettering: Reducing the risk of wrong drug errors … Beyond mixed case lettering: Reducing the risk of wrong drug errors requires a multimodal response. … Principal Investigator Lambert, Bruce Project Name Preventing Wrong-Drug and Wrong-Patient Errors … Project Name Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of … Editorial: Helping health care organizations to define diagnostic errors as missed opportunities in diagnosis

139. University of Illinois at Chicago | Digital Healthcare Research
     digital.ahrq.gov/organization/university-illinois-chicago
     January 01, 2023 - Description This research studied whether clinical decision support could reduce contextual errors … Principal Investigator(s) Weiner, Saul An Etiology for Medication Ordering Errors … Order Entry Systems Description This research assessed the etiology of medication ordering errors … , finding that errors stemmed from multi-level risk factors and showing the utility of a void alert tool … to prospectively capture the broad range of errors that may occur in practice that may be missed by

140. Effect of bar-code technology on the incidence of medication dispensing errors and potential adverse drug events in a hospital pharmacy | AHRQ Digital Healthcare Research: Informing Improvement in Care Quality, Safety, and Efficiency
     digital.ahrq.gov/health-it-tools-and-resources/health-it-costs-and-benefits-database/effect-bar-code-technology
     January 01, 2005 - Effect of bar-code technology on the incidence of medication dispensing errors and potential adverse … Safety Outcome:  Compared to the pre-intervention period, barcoding reduced the risk of dispensing errors … Extrapolation to one year, this would equate to a reduction in 13,000 dispensing errors and 6,000 potential