Electronic System Demonstrates Potential to Reduce the Risk of Adverse Drug Events
The use of an electronic application and a revision to the medication reconciliation process can significantly decrease the number of potentially harmful medication discrepancies.
Boston, MA, May 20, 2009 --(PR.com)-- Researchers at Brigham and Women’s and Massachusetts General Hospitals report that using a computerized application to record and track patients’ medications could decrease the occurrence of potentially harmful medication discrepancies. These findings appear in the April 27 issue of Archives of Internal Medicine.
Medication discrepancies describe the unexplained differences in medication regimens that occur as patients move through the health care system, which have the potential to lead to adverse drug events. To address this issue, hospitals use medication reconciliation, the process of correctly identifying all the medications a patient was taking before the hospitalization and using the list to correctly order medications during their hospital stay and at discharge.
“Improving medication reconciliation is an important patient safety goal across the medical field,” said Jeffrey Schnipper, MD, MPH, senior author and hospitalist at BWH. “We found that in the hospital setting, with the use of an electronic application and a revision to the reconciliation process, there is a 28 percent reduction in the number of potentially harmful medication discrepancies that can happen at admission or discharge.”
Participants in the study were randomly assigned based on the medical team and floor to which they were admitted at one of the two participating hospitals. One half of the participants received traditional procedures for medication reconciliation. The second group of participants- those in the intervention group, were assigned to a medical team that used a new Web-based computer application that pooled medication information from several electronic sources, making it easier to take the medication history and track medication lists until discharge.
The intervention also included reassigning roles, including greater involvement of pharmacists to confirm that medications taken before the hospitalization were appropriately ordered in the hospital and greater use of nurses to confirm the accuracy of the medication history. “The redesign streamlined the process and eliminated redundant history-taking what was being performed in silos and replacing it with collaboration between doctors, nurses, and pharmacists,” said Dr. Schnipper.
Patients in the intervention group still averaged one potentially harmful medication discrepancy after the reduction in risk, compared with 1.4 errors in the control group. “We have found a way to address a number of problems with medication reconciliation, but there is still a need to improve the process further, especially concerning issues of patient and caregiver inaccuracy when reporting medication histories, the lack of compliance with the process from medical staff, and software usability issues,” said Dr. Schnipper.
The research was funded by Brigham and Women’s Hospital, Massachusetts General Hospital, Partners Healthcare and Harvard Risk Management Foundation.
About Brigham and Women's Hospital
Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit www.brighamandwomens.org
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Medication discrepancies describe the unexplained differences in medication regimens that occur as patients move through the health care system, which have the potential to lead to adverse drug events. To address this issue, hospitals use medication reconciliation, the process of correctly identifying all the medications a patient was taking before the hospitalization and using the list to correctly order medications during their hospital stay and at discharge.
“Improving medication reconciliation is an important patient safety goal across the medical field,” said Jeffrey Schnipper, MD, MPH, senior author and hospitalist at BWH. “We found that in the hospital setting, with the use of an electronic application and a revision to the reconciliation process, there is a 28 percent reduction in the number of potentially harmful medication discrepancies that can happen at admission or discharge.”
Participants in the study were randomly assigned based on the medical team and floor to which they were admitted at one of the two participating hospitals. One half of the participants received traditional procedures for medication reconciliation. The second group of participants- those in the intervention group, were assigned to a medical team that used a new Web-based computer application that pooled medication information from several electronic sources, making it easier to take the medication history and track medication lists until discharge.
The intervention also included reassigning roles, including greater involvement of pharmacists to confirm that medications taken before the hospitalization were appropriately ordered in the hospital and greater use of nurses to confirm the accuracy of the medication history. “The redesign streamlined the process and eliminated redundant history-taking what was being performed in silos and replacing it with collaboration between doctors, nurses, and pharmacists,” said Dr. Schnipper.
Patients in the intervention group still averaged one potentially harmful medication discrepancy after the reduction in risk, compared with 1.4 errors in the control group. “We have found a way to address a number of problems with medication reconciliation, but there is still a need to improve the process further, especially concerning issues of patient and caregiver inaccuracy when reporting medication histories, the lack of compliance with the process from medical staff, and software usability issues,” said Dr. Schnipper.
The research was funded by Brigham and Women’s Hospital, Massachusetts General Hospital, Partners Healthcare and Harvard Risk Management Foundation.
About Brigham and Women's Hospital
Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit www.brighamandwomens.org
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Suzanne Benz
(617) 534-1600
http://www.brighamandwomens.org
75 Francis Street
Boston, MA 02115 USA
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