Patient Safety & Quality Improvement USMLE Step 1 Practice Question
A 250-bed community hospital implements a new computerized physician order entry (CPOE) system with real-time drug interaction alerts to reduce medication errors in the intensive care unit. Before implementation, a retrospective chart review over 6 months identified 36 medication errors among 800 ICU admissions (4.5% error rate). Three months after CPOE deployment, the quality improvement team reviews 750 ICU admissions and identifies 18 medication errors (2.4% error rate). Patient outcomes remain stable with no increase in adverse drug events, hospital-acquired infections, or length of stay. Which of the following methods is most appropriate for determining whether this CPOE intervention has achieved a sustained reduction in medication errors?
Answer choices
- ASurvey prescribers and nurses regarding their confidence in the new medication ordering system
- BCalculate the return on investment by comparing system implementation costs to prevented adverse events
- CCompare pre- and post-implementation medication error rates using statistical process control charts (run charts or control charts) to assess for sustained improvementCorrect answer
- DCount the number of drug interaction alerts triggered by the CPOE system during the intervention period
- EAssess rates of alert fatigue by tracking how often clinicians override automated safety alerts
- FMeasure time to medication administration before and after CPOE implementation
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