Who should take a CPOE Evaluation Tool?
Adult and general hospitals that have CPOE implemented in at least one inpatient unit of the hospital are asked to complete a CPOE Evaluation Tool as part of Section 2 of the Leapfrog Hospital Survey. The testing of a hospital’s CPOE system is a key part of the Leapfrog Hospital Survey and all survey deadlines apply to the CPOE Evaluation Tool as well.
What is the CPOE Evaluation Tool?
The CPOE Evaluation Tool was designed by medication safety experts and researchers at Brigham and Women's Hospital and the University of Utah to test the ability of inpatient CPOE systems to alert prescribers to common, serious medication errors. In addition, the tool was designed to help hospital's improve on their use of clinical decision support to reduce adverse drug events and improve medication safety. The tool was first included on the Leapfrog Hospital Survey in 2008. This is the third release of the tool (version 3.0) and includes updates to test patients and orders, as well as an updated user interface and time limits.
The CPOE Evaluation Tool includes both a Sample Test and an Adult Inpatient Test. All hospitals are urged to complete the Sample Test prior to the Adult Inpatient Test. Only a hospital's score on the Adult Inpatient Test is used to determine their overall performance on Leapfrog's CPOE Standard.
The timed test provides users with a set of test patients, along with a corresponding set of test medication orders, that users enter into their hospital’s CPOE and related clinical systems. Those conducting the test record the advice or information they received, if any, from their hospital’s CPOE system onto an observation sheet, and then record then complete an online answer sheet. Users receive immediate scoring and feedback summarizing the results of the test. The Tool includes several order checking categories including drug:drug interaction, drug:allergy interactions, therapeutic duplications, single and daily dose limits, and others. More information about the order checking categories included in the CPOE Evaluation Tool is available in the CPOE Evaluation Tool Scoring document.
How Do I Access CPOE Evaluation Tool?
Hospitals can access the CPOE Evaluation Tool from the Survey Dashboard, once they have submitted Sections 1 and 2 of the online survey. Users can return to complete and submit the rest of the survey at a later date (Sections 3-9). Due to updates to the CPOE Evaluation Tool, the Tool will not be accessible from the Survey Dashboard until April 15th.
How is the Test Conducted?
Once you submit Sections 1 and 2 in the online survey tool, the “CPOE Tool” button will appear on the Survey Dashboard. A brief hospital information form will need to be completed. Once the form is complete, continue on to the next screen to select a Sample or Adult Inpatient Test from the dropdown menu.
Time Limits and Steps
|Time Limits||Test Steps|
|Steps 1 - 2 must be completed within 3 hours.||
Step 1: (a) Print a list of Test Patients and (b) log out of the tool.
Step 2: (a) Set up the Test Patients in your hospital's production environment (or a test environment that mirrors your production environment exactly) and (b) log back into the tool to confirm completion of Step 2 and proceed to Step 3.
Steps 3 - 6 must be completed with 3 hours.
Any remaining time from Steps 1 and 2 does not carry over to this portion of the test.
We recommend leaving at least 45 minutes to perform Step 5.
Step 3: (a) Print the Orders and Observation Sheet and (b) log out of the tool.
Step 4: (a) Have a prescriber who routinely orders medications through your inpatient CPOE system enter and sign the test orders(s) assigned to east test patient (b) the prescriber must record any advice or information he/she receives from the system onto the Orders and Observation Sheet (c) discontinue the order(s) before moving on to the next order and then (d) log back into the tool to confirm completion of Step 4 and proceed to Step 5.
Note: Do not record any advice or information on the Orders and Observations Sheet that was sent directly to a pharmacist.
Step 5: (a) Record the responses from the Orders and Observation Sheet onto the online answer sheet (b) review the online answer sheet for accuracy and completeness (c) submit the online answer sheet and (d) move on to Step 6.
Step 6: Complete and submit the affirmation.
IMPORTANT NOTICE: If you close the browser before submitting the affirmation the hospital will receive a score of "Incomplete Evaluation" and you will not be able to return to the test for 120 days.
|Step 7 has no time limit.||Step 7: View and print your results.|
The same time limit applies to both the Sample and Adult Inpatient Tests. For each test started, you have:
- 3 hours elapsed time to complete Steps 1-2, then
- 3 hours elapsed time to complete Steps 3-6
Elapsed time runs continuously, 24/7, and is not interrupted or suspended during “non-business hours.” If you exceed these time limits, the CPOE Tool will "time out" and consider the test “incomplete.” The test will be recorded in the online survey as “Incomplete Evaluation” and Leapfrog will not give credit to your hospital for taking that test. It is not possible to go back to a previous step in the test.
More detailed information, including how to plan for the test, is available in the CPOE Evaluation Tool Instructions.
How is the CPOE Evaluation Tool scored?
More information about the CPOE Evaluation Tool scoring can be found in Scoring and Results.
How Will the Results Be Used?
Results from the CPOE Evaluation Tool will be combined with a hospital’s CPOE implementation status to determine its overall score on the CPOE standard. More information is available in Scoring and Results.
Are you ready to start a test? Download the detailed set of instructions here.