Preventing Medication Errors in Hospital
Role of the Hospital Pharmacist in Preventing Medication Errors
To understand how hospitals can reduce medication-related medical errors, Michael Wong, JD (Executive Director, Physician-Patient Alliance for Heath & Safety) recently spoke with Steven Meisel, PharmMD, who is a patient safety expert at the Institute for HealthCare Improvement (IHI). Steven is also Director of Medication Safety at Fairview Health Services in Minneapolis.
Hospital pharmacists receive orders to fill prescriptions for opioids from units and doctors throughout the hospital, so pharmacists are in a unique position to prevent potential adverse events from occurring throughout the facility.
From 2008 through 2016, Fairview Health Services university hospital had an 82% reduction in narcotic related adverse events. To achieve positive reductions in opioid-related adverse events, in the clinical education podcast, Mr. Meisel urged hospitals to recognize that they may have a problem with opioid-related adverse events - doing so, is the first step in improving patient safety and care:
"Just like the alcoholic can't change his ways and get better before he admits he is an alcoholic. The hospital can't reduce its risk for narcotic over sedation until it believes that there is a risk for narcotics over sedation."
Mr. Meisel also recommends making sure that an executive is in charge of looking at the medication data and that the hospital measures the steps that it has taken:
The second is to make sure that there is somebody who is in charge of this, somebody is appointed to be the point person to look at the data, to review whatever naloxone administrations are given, identify the risk factors and the commonalities and all of that and to begin to identify what changes ought to happen whether it's in monitoring or prescribing or dispensing or whatever it may be that would help improve the situation. Third is to measure. You can't improve what you can't measure, at least not very well. So, what we have for the last ten years or more, we have a run chart to every quarter, where we have the number of narcotic related adverse drug events plotted over time, by hospital and as an aggregate, and we post that regularly to be reviewed by our pain committee, reviewed by our pharmacy therapeutics committee and others. And, so we have that measure, we know whether we're getting better, staying the same, or in some cases at times getting worse, if that's the case.
To listen to the podcast, please click here. https://youtu.be/
About Physician-Patient Alliance for Health & Safety
Physician-Patient Alliance for Health & Safety is a non-profit 501(c)(3) whose mission is to promote safer clinical practices and standards for patients through collaboration among healthcare experts, professionals, scientific researchers, and others, to improve healthcare delivery. For more information, please go to www.ppahs.org.