Slide Presentation from the AHRQ 2007 Annual Conference

The Big Question

• Can the types of errors and events that I shared with you be captured with a set of quality measures that can guide the development of computerized clinical decision support systems in the long-term care setting?

Notes:

Study establishes the extent and seriousness of the problem
clarifies the potential for prevention
lays the ground work for determining what directions needed in designing interventions
We believe this is a very conservative estimate—tip of the iceberg, because:
used medical record review—limits in quality of nursing home records strictly information entered or reported by providers
high end homes rigid about definition of ADE—had to be strong evidence linking symptoms to drug