Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool
This is a review of Leung, A. A., Keohane, C., Lipsitz, S., Zimlichman, E., Amato, M., Simon, S. R., Coffey, M.,Kaufman, N., Cadet, B., Schiff, G., Seger, D.L., & Bates, D.W. 2013 article, “Relationship between medication event rates and the Leapfrog computerized physician order entry evaluation tool”.
The objective of this article was to evaluate the Leapfrog CPOE evaluation tool for its effectiveness and assess the relationship between Leapfrog scores and the rates of preventable adverse drug events (ADE) and potential ADEs. The Leapfrog Group developed this tool to assess the performance of a hospital’s CPOE system by using simulated cases. “The Leapfrog CPOE evaluation tool estimates the potential benefit of a CPOE system by testing how it handles a variety of dangerous medication ordering scenarios”.
To determine the relationship between leapfrog scores and the rates of preventable and potential ADEs a cross-sectional study was performed. There were 1000 adult admissions evaluated in five community hospitals in Massachusetts. The authors used random sampling as there were 200 patients that were selected from each site. Observed rates of preventable and potential ADE were compared with scores reported by the Leapfrog CPOE evaluation tool. “The Leapfrog CPOE evaluation tool examines how a system with clinical decision support is able to intercept a variety of potentially dangerous medication order using a variety of simulated clinical scenarios” . The Leapfrog Evaluation tool “has evolved into a well-balanced survey of hospital quality and safety, focusing on hospital structures, processes of care, and outcomes” .
Results and Discussion
The authors found that Leapfrog scores were highly related to the rate of preventable ADEs. It was noted that there was “a 43% relative reduction in the rate of preventable ADE was predicted for every 5% increase in Leapfrog scores (rate ratio 0.57; 95% CI 0.37 to 0.88)” . The authors also found that there was a 5% improvement in Leapfrog scores associated with the relative rate reduction in preventable ADE by half to 100 hospital admissions. The authors of this articles’ findings therefore support the use of the Leapfrog tool as another means of evaluating a CPOE after implementation.
This study was an interesting study as I was not familiar with the Leapfrog group and its association with the healthcare industry. It was interesting to read about the tool they developed in response to addressing ADEs with a CPOE evaluation tool. I am sure there are other tools and formats out there in which a CPOE may be evaluated. However, I was really impressed with this study’s findings and its implications for improving CPOE performance and monitoring throughout a healthcare facility. This tool will also be able to give providers feedback on system vulnerabilities and serve as an outline for areas of improvement.
- Leung, A. A., Keohane, C., Lipsitz, S., Zimlichman, E., Amato, M., Simon, S. R., Coffey, M.,Kaufman, N., Cadet, B., Schiff, G., Seger, D.L., & Bates, D.W. (2013). Relationship between medication event rates and the leapfrog computerized physician order entry evaluation tool. J AM Med Inform Assoc., 20(e1), e85-e90. doi: 10.1136/amiajnl-2012-001549 Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/23599225
- Leapfrog hospital survey: About the survey. (2015). Retrieved from https://leapfroghospitalsurvey.org/about-the-survey/