Benchmarking Error
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for benchmarking. Yet, we must question the wisdom of applying the benchmarking concept to the medication use process when the focus is on error rates. The true incidence of medication errors varies, depending medication error benchmark heavily on the rigor with which the events are identified and reported.. Certainly, the benchmark tracking error confusion surrounding the term "benchmarking"perpetuates the myth that one can gauge the quality and safety of the medication use process simply national benchmark for medication errors by comparing error rates, both within an organization and externally. Benchmarking is an ongoing process that determines how other organizations have achieved the best performance and suggests ways for adapting the best practices that result
Benchmark Data For Medication Errors
in this exceptional performance. Although measurement is one of its components, effective benchmarking is a dual process that requires two products: benchmarks and enablers.1 Benchmarks are measures of comparative performance that answer the question: "What is your level of performance?" Alone, this information has little use in improving performance. Benchmarking must also provide a systematic method of understanding the underlying processes that determine organizational performance. To that end, enablers rate of medication errors in hospitals must be identified. Enablers are the specific practices that lead to exemplary performance and answer the question: "How do you do it?" Overlooking either one of these components in the benchmarking process renders it useless, even dangerous! Currently, there is no consistent process among healthcare organizations for detecting and reporting errors. Since many medication errors cause no harm to patients, they remain undetected or unreported. Still, organizations frequently depend on spontaneous voluntary error reports alone to determine a medication error rate. The inherent variability of determining an error rate in this way invalidates the measurement, or benchmark. A high error rate may suggest either unsafe medication practices or an organizational culture that promotes error reporting. Conversely, a low error rate may suggest either successful error prevention strategies or a punitive culture that inhibits error reporting. Also, the definition of a medication error may not be consistent among organizations or even between individual practitioners in the same organization. Thus, spontaneous error reporting is a poor method of gathering "benchmarks;"it is not designed to measure medication error rates. Of equal concern is the mistaken belief that benchmarking is simply comparing numbers.2 Although not meaningful, healthcare organizations have embraced the practice of comparing error rates. Yet, there has been littl
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2012 More thoughts on having less benchmarking Following up on Catherine Carson's comment on the inadvisability of using benchmarks for certain patient safety goals, another person on the the National Patient Safety Foundation's listserv pointed out that the Institute for Safe Medication Practices has always maintained a position against benchmarking for medication errors. Here are excerpts from the ISMP website, responding to the questions, "What is the national medication error rate? What standards are available for benchmarking?" A national or other regional medication error rate does not exist. It is not possible to establish a national medication error rate or set a benchmark for medication error rates. Each hospital or organization is different. The rates that are tracked are a measure of the number of reports at a given institution not the actual number of events or the quality of the care given. Most systems for measuring medication errors rely on voluntary reporting of errors and near-miss events. Studies have shown that even in good systems, voluntary reporting only captures the "tip of the iceberg." For this reason, counting reported errors yields limited information about how safe a medication-use process actually is. It is very possible that an institution with a good reporting system, and thus what appears to be a high error "rate," may have a safer system. In addition, on June 11, 2002, the National Coordinating Council for Medication Error Reporting and Prevention published a statement refuting the use of medication error rates, [asserting that] the "Use of medication error rates to compare health care organizations is of no value." The Council has taken this position for the following reasons: Differences in culture among healthcare organizations can lead to significant differences in the level of reporting of medication errors. Differences in the definition of a medication error among healthcare organizations can lead to significant differences in the reporting