Date of Award

2019

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Abby Swanson Kazley

Second Advisor

James A. Johnson

Third Advisor

Kit N. Simpson

Abstract

The current dissertation study analyzes whether the volume of medication errors in which years prior to the adoption and implementation of the HITECH / Meaningful Use Act or the EHR (2007-2010) was higher, lower, or remained unchanged versus in which years after implementation of the Meaningful Use Act / HITECH Act (2011-2014). The study employed secondary data sources from the Center for Drug Evaluation and Research (CDER) / Healthcare Cost and Utilization Project (HCUP). A time series analysis was used to assess the effect of the regulation implementation. Purpose: Medical errors ranked as the third top leading cause of all hospital deaths in the United States, and as many as 400, 000 patients are harmed annually, as a result of preventable medical errors. This problem creates the need to enhance patient safety in the US. Methods: Medication error was measured using the monthly recorded Rxper OE variable (medication error percent as a % of the total non-medication medical errors of the month).The Rxper OE was recorded from 2007 -2014, and data analyzed to make an inference as to whether the volumes of medication errors increased, decreased, or stayed the same between the years 2007 to 2014. Scope: Medical errors, a major challenge facing the US healthcare system, are found in every region of the country. To address this problem as well as improve the overall quality of care, the US government implemented the HITECH Act / Meaningful Use Act on February 17, 2009. Results and Findings: Although medication errors in the U.S. increased as a proportion of all medical errors after the implementation of the HITECH Act (6.78% versus 7.98% Averages), those proportional increases were due to a decrease in non-medication / other types of medical errors, while the rate of the medication errors overall remained stable. This trend was further explored, and found to only increase by 6%/year after 2011, with a p-value of (p=0.6397), which is not statistically significant. Conclusion: The study findings do not support the hypothesis that there was a change in the volume or levels of in-hospital medication errors between the Pre-and Post-Electronic Health Records (EHR) timeframe. Recommendations: Recommendations included the following 7 ideas: Employee (re)training and Awareness campaigns; strategic recruitment; effective policy; problem acknowledgment and transparent reporting; patient-centeredness; problem solving / documentation, and being proactive (versus reactive).

Rights

All rights reserved. Copyright is held by the author.

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