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81. Bedside Notes: A Multicenter Trial to Improve Family Clinical Note Access and Outcomes for Hospitalized Children | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/bedside-notes-multicenter-trial-improve-family-clinical-note-access-and
    September 30, 2024 - anxiety, and enhance their ability to partner with the clinical team to identify and intercept medical errors … Patient Engagement Patient Safety Hospitalized children experience harm from medical errors … urgent need for clinicians and caregivers to collaborate in sharing information to prevent potential errors … research aims to advance pediatric inpatient care by leveraging digital health tools to reduce medical errors

82. Steele AW et al. 2005 "The effect of automated alerts on provider ordering behavior in an outpatient setting." | Digital Healthcare Research
    digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/experience-research/steele-aw-et
    January 01, 2023 - Abstract "Background: Computerized order entry systems have the potential to prevent medication errors … prescribed in the outpatient setting, few studies have assessed the impact of automated alerts on medication errors … Implementation of rules technology to prevent medication errors could be an effective tool for reducing … medication errors in an outpatient setting." … Objective To assess "the impact of automated alerts on medication errors related to [missing or abnormal

83. Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of Clinical Decision Support - Final Report (pdf file)
    digital.ahrq.gov/sites/default/files/docs/citation/k08hs24764-nanji-final-report-2022.pdf
    January 01, 2022 - Evaluation of Perioperative Medication Errors and Adverse Drug Events. … Medication errors observed in 36 health care facilities. … Medication errors and adverse drug events in pediatric inpatients. … Errors associated with outpatient computerized prescribing systems. … Observation method of detecting medication errors.

84. 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.

85. 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

86. 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

87. Electronic Health Record Solutions for Accurate Reporting of Data on Interprofessional Intensive Care Unit Rounds | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/electronic-health-record-solutions-accurate-reporting-data-interprofessional
    January 01, 2023 - Project Description Publications The issue of communication errors … (IP) rounds–that include participation by the entire care team--improves communication and reduces errors … This research identified the data domains at greatest risk for communication errors during ICU rounds … and the role that the EHR and clinical users have in the genesis of these errors. … of the research were: Determine frequency of and the factors responsible for data communication errors

88. Shachak A et al. 2009 "Primary care physicians' use of an electronic medical record system: a cognitive task analysis." | Digital Healthcare Research
    digital.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit/research/shachak-et-al-2009
    January 01, 2009 - Record (EMR) system; to reveal the underlying cognitive elements involved in EMR use, possible resulting errors … Automaticity of EMR use contributed to efficiency, but sometimes resulted in errors, such as the selection … "EMR use provoked new types of medical errors. … Typical errors reported by most study participants (>60%) were typos, adding information to the wrong … "The findings indicate that study participants were aware of these potential errors.

89. Assess Risk of Wrong Patient Errors in an EMR that Allows Multiple Records Open - Final Report (pdf file)
    digital.ahrq.gov/sites/default/files/docs/citation/r21hs023704-adelman-final-report-2019.pdf
    January 01, 2019 - errors 2. … These errors occurred among attending physicians (60 errors per 100,000 orders), nurse practitioners … and physician assistants (74 errors per 100,000 orders), and pharmacists (67 errors per 100,000 orders … However, near-miss errors follow the same causal pathway as errors that cause harm, and their use to … , wrong-patient errors 2.

90. Statewide Implementation of Electronic Health Records | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/statewide-implementation-electronic-health-records
    January 01, 2023 - Type of Care Primary Care Specialty Care Health Care Theme Medication Errors … 2) To what extent will adoption of EHRs reduce medication errors and improve the quality of ambulatory … Understanding the nature of medication errors in an ICU with a computerized physician order entry system … Ambulatory prescribing errors among community-based providers in two states. … Are physicians' perceptions of healthcare quality and practice satisfaction affected by errors associated

91. Abraham, Joanna | Digital Healthcare Research
    digital.ahrq.gov/principal-investigator/abraham-joanna
    January 01, 2024 - Risk factors associated with medication ordering errors. … Predicting self-intercepted medication ordering errors using machine learning. … Abraham, Joanna Arora, Vineet An Etiology for Medication Ordering Errors in … An Etiology for Medication Ordering Errors in Computerized Provider Order Entry Systems - Final Report … to prospectively capture the broad range of errors that may occur in practice that may be missed by

92. Context is Critical: Understanding When and Why Electronic Health Record-Related Safety Hazards Happen | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/context-critical-understanding-when-and-why-electronic-health-record-related
    January 01, 2023 - , and then put in systems to capture the context around errors. … to understand what factors lead to EHR-facilitated errors.  … Five error types were explored: wrong-route errors, wrong-weight errors, wrong-sided errors, free-text … order errors, and wrong-route-order errors. … , and then put in systems to capture the context around errors.

93. Improving Patient Safety/Quality with Health Information Technology Implementation | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/improving-patient-safetyquality-health-information-technology-implementation
    January 01, 2023 - Type of Care Acute Care Health Care Theme Adverse Events Medication Errors … Further, we designed around precarious events, specifically medication errors, by identifying the prevalence … of medication errors, near misses and preventable adverse drug events in our current manual patient … around patient safety and supported by a centralized IT system that will help the hospital prevent errors … These included: operative and post-operative complications and infections, medication errors, patient

94. Basco, William | Digital Healthcare Research
    digital.ahrq.gov/principal-investigator/basco-william
    January 01, 2023 - William Assessment of Pediatric Look-Alike, Sound-Alike Substitution Errors … Assessment of Pediatric Look-Alike, Sound-Alike Substitution Errors - Final Report. … Assessment of Pediatric Look-Alike, Sound-Alike Substitution Errors - 2012 … Using pharmacy data to screen for look-alike, sound-alike substitution errors … Assessment of Pediatric Look-Alike, Sound-Alike (LASA) Substitution Errors -

95. Brown, Andrew | Digital Healthcare Research
    digital.ahrq.gov/principal-investigator/brown-andrew
    January 01, 2023 - Principal Investigator Brown, Andrew Project Name Detecting Med (Medication) Errors in … Principal Investigator Brown, Andrew Project Name Detecting Med (Medication) Errors in … Principal Investigator Brown, Andrew Project Name Detecting Med (Medication) Errors in … Detecting Med Errors in Rural Hospitals Using Technology -Final Report. … Rural Hospitals Using Technology Detecting Med (Medication) Errors in Rural

96. Medication Reconciliation to Improve Quality of Transitional Care - 2011 | Digital Healthcare Research
    digital.ahrq.gov/ahrq-funded-projects/medication-reconciliation-improve-quality-transitional-care/annual-summary/2011
    January 01, 2011 - Period September 2009 - September 2012 AHRQ Funding Amount $1,181,628 Summary: Medication errors … account for approximately 20 percent of all medical errors in the United States each year. … facilitation of inpatient MR improves completion of MR and decreases the incidence of drug-related medical errors … Determine whether electronic facilitation alters medical reconciliation and the incidence of medication errors

97. How Capable of Using Information Technology is the Average Patient? (pdf file)
    digital.ahrq.gov/sites/default/files/docs/page/2006FriedmanSantinonFormica_052411comp.pdf
    June 16, 2021 - 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?

98. Develop and Validate Health IT Safety Measures to Capture Violations of the 5 Rights of Medication Safety – Final Report (pdf file)
    digital.ahrq.gov/sites/default/files/docs/citation/r01hs024538-adelman-final-report-2022.pdf
    January 01, 2022 - remain the most common types of medication errors.8 These analyses were conducted using errors … This framework distinguishes between Planning Errors, defined as errors in which the intended action … incorrectly.35 Planning Errors were further classified as Knowledge Errors, which occur because of … For example, 97% of Wrong-Patient order errors were execution errors, resulting from slips such as … errors, predominantly resulting from rule-based errors in which clinicians failed to adjust for the

99. Nanji, Karen C. | Digital Healthcare Research
    digital.ahrq.gov/principal-investigator/nanji-karen-c
    January 01, 2023 - Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of Clinical Decision … Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of Clinical Decision … Project Name Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of … Project Name Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of … Project Name Preventing Perioperative Medication Errors and Adverse Drug Events Through the Use of

100. Lambert, Bruce | Digital Healthcare Research
     digital.ahrq.gov/principal-investigator/lambert-bruce
     January 01, 2023 - Lambert, Bruce Preventing Wrong-Drug and Wrong-Patient Errors With Indication … Preventing Wrong-Drug and Wrong-Patient Errors With Indication Alerts in CPOE Systems – Final Report. … Automated detection of wrong-drug prescribing errors. … Automated detection of look-alike/sound-alike medication errors. … Learning from errors: analysis of medication order voiding in CPOE systems.