How do N.J. hospitals compare when preventing medication errors?

Hospitals in New Jersey and nationwide are making increased use of computerized medication ordering systems that are designed to prevent medication errors. And yet too often these systems don’t work as well as they should, according to a new study by the Leapfrog Group, the nonprofit hospital watchdog.In New Jersey, 61 of the state’s 70 acute care general hospitals participate in the voluntary Leapfrog Hospital Survey, which evaluates hospital quality across a wide range of clinical benchmarks, from hospital acquired infections to surgical errors.

To test the performance of these systems, the Leapfrog hospitals ran a simulation that feeds fictitious patient data into the hospital’s computer system, then sees whether it flags prescribing errors — like ordering an adult dose for a child or prescribing a drug that interacts negatively with another medication the patient takes.

To meet the Leapfrog standard, a hospital must use the simulation for at least 75 percent of the medications that doctors prescribe to patients. And the hospital’s system should catch at least 50 percent of prescribing errors.

New Jersey hospitals outperformed the national average in the 2014 simulation, according to Leapfrog: 64 percent of New Jersey hospital met the standard, compared to 59 percent nationwide.

New Jersey and the nation have made strides over the past five years, according to Leapfrog.  In 2010, only 10 percent of New Jersey’s Leapfrog hospitals met the Leapfrog standard, compared to 64 percent in 2014. Nationally 59 percent of Leapfrog hospital hit the standard in 2014, compared with 14 percent in 2010.

But the simulation results show that computerized medication ordering systems are no panacea.  The rate of potentially harmful medication orders that failed to trigger an appropriate warning remained at 36 percent in both 2013 and 2014, and the number of potentially fatal medication orders that weren’t flagged was nearly 14 percent for both years.

Leapfrog spokeswoman Erica Mobley said there are a number of different computer drug ordering systems used by hospitals.

“Hospitals have the ability to customize their system in many different ways: it’s not a plug and play system. They have to customize it to the different medications that are used at that hospital and the different types of patients and conditions they might treat. And then they have to make sure their staff is using it correctly,” she said.

Leah Binder, chief executive of Leapfrog, said that while these computer systems help prevent errors, they are “imperfect, and hospitals need to keep in place the checks and double-checks to make sure patients are not given the wrong medication.”

According to Leapfrog, medication errors are the most common mistakes hospitals make, and cited studies that estimate preventable medication errors affect 3.8 million patients in the U.S. annually.

Linda Schwimmer, vice president of the New Jersey Health Care Quality Institute and a member of the Leapfrog board, said, “We are pleased to note that New Jersey hospitals exceeded the national average of hospitals that met the Leapfrog standard.”

 “It is a positive sign that so many hospitals are proactively trying to reduce these errors by instituting computerized prescribing systems,” Schwimmer said.

Medication errors “are the most common mistakes made in hospitals, but they are also some of the most preventable mistakes. That’s why installing these systems and using them effectively is important for patient safety, which is a top priority” for the institute, she said.

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How do N.J. hospitals compare when preventing medication errors?