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Journal Article > Study
Longo DR, Hewett JE, Ge B, Schubert S. JAMA. 2005;294:2858-2865.
To grade progress since release of the landmark Institute of Medicine (IOM) report, this AHRQ-funded study examined the status and evolution of patient safety systems through a survey of acute care hospitals in Missouri and Utah. Investigators characterized their assessment based on variables that included presence of computerized physician order entry systems, computerized test results, evaluation of adverse drug events, specific patient safety policies, use of data in patient safety programs, drug administration and safety procedures, error reporting processes, prevention policies, and root cause analyses. More than 100 hospitals completed the survey in 2002 and again in 2004. Findings demonstrated only modest improvements in certain areas with variability noted in others. For instance, surgical areas and medication processes seemed to embrace the greatest level of patient safety systems. However, the authors point out that the overall findings fall short of the IOM recommendations and necessitate a more intensive agenda for accelerated improvements. An accompanying editorial (link below) provides an overview of the factors and challenges involved in promoting change to improve patient safety.
Journal Article > Study
Cutler DM, Feldman NE, Horwitz JR. Health Aff (Millwood). 2005;24:1654-1663.
This study discovered that implementation of computerized physician order entry (CPOE) systems is a greater reflection of hospital ownership and teaching status than hospital profitability. Using Leapfrog survey data derived from their efforts to reward CPOE adoption, investigators present findings from hospitals with varying degrees of operational CPOE systems. While many have argued that limitation in resources prevents wider implementation, these findings counter those explanations. Interestingly, government hospitals represented the most likely adopters and for-profit organizations the least likely, adding to the notion that these systems are not intended to provide significant profits. Findings suggest that other factors, such as caring for the sickest patients or political interests in safety, may partly explain the results. The authors express concern that less than 5% of hospitals are in compliance with CPOE standards and that changes in the reimbursement environment through federal initiatives may provide necessary stimulus.