Section 1
https://www.mdcalc.com
Use the link above or download MDcalc app on your smart phone.
Explore the “Popular” and “All” menu’s for all the different calculated that are available. Pick one or more calculators and try to enter normal and abnormal entries to explore different outcomes as well as next steps that are recommended. Answer the following questions:
1. Which calculator did you pick?
2. Discuss the results you received and the recommended next steps.
3. What do you think about MDcalc in relation to CDSS?
Note: Some calculators do not present next steps, choose one that does.
Section 2
2. Find some resources using Google which are considered pro and con regarding CPOE and patient safety. Discuss why there is conflict in the literature.
Section 3
3. Go to HealthGrades web site and compare your local hospitals for quality rating for common surgeries. Were there any surprises? Discuss your answer. ( my local hospitals are in NYC) you can choose Brooklyn Methodist hospital and /or kings county hospital.
Section 4
4. Consider the following case study:
Case Study:
Reduce medication errors with a closed-loop medication administration system Contributors: Kareen Hall-Clarke, MPH, FACHE, CPHIMS, Seneca College, ON & Alstair Forsyth, MHSc, North York General Hospital, ON, Canada North York General Hospital (NYGH) serves the culturally diverse communities of North Toronto and provides acute, ambulatory and long-term care services across three sites serving 400,000 people. In 2007, it embarked on a multi-year clinical transformation project to bring its EHR into the future, from HIMSS Stage 2 to a goal of HIMSS Stage 7. In 2010, NYGH implemented the eCare Project with a primary focus of improving the quality and safety of care. In 2004, the Canadian Adverse Events Study (CAES) 1 reviewed acute care hospitals across the country and found that 7.5% of those had an adverse event and 45% were related to medication services. One of NYGH first eCare initiatives was to redesign its medication administration process. Prior to eCare, the medication process consisted of handwritten physician orders, duplicative manual transcription and shared med carts. This system left a lot of room for error, with 39 percent of errors occurring with medication prescribing and 38 percent occurring with medication administration. After examining the local problem and designing a new workflow to solve that problem, NYGH implemented closed-loop medication administration (CLMA), (See Figure 1). By leveraging information technology CLMA eliminates manual entry and sends an alert if a medication about to be administered does not match the drug, dose, route, timing and/or intended patient indicated in the active orders in the electronic chart. From 2010-2015, NYGH has prevented more than 11,000 medication errors using CLMA.
1 Baker, G. R., P. G. Norton, V. Flintoft, R. Blais, A. Brown, J. Cox, E. Etchells, W. A. Ghali, P. Hebert, S. R. Majumdar, M. O’Beirne, L. Palacios-Derflingher, R. J. Reid, S. Sheps and R. Tamblyn (2004). “The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada.” CMAJ Canadian Medical Association Journal 170 (11): 1678-1686.
Answer the following questions:
1. How should medication errors be addressed at each step of the eMAR process: Prescribing, Transcribing, Dispensing and Administration?
2. Why should closed-loop medication administration (CLMA) technologies be the last defense to medication errors in the delivery of optimum patient care and safety?