Using a computerized discharge summary data base check box for adverse drug reaction monitoring

The Joint Commission on Accreditation of Healthcare Organizations and the Food and Drug Administration (FDA) have encouraged hospitals to develop mechanisms to improve reporting of adverse drug reactions (ADRs). Cook County Hospital, in Chicago, introduced a check box on a computerized discharge summary form on which the physician codes for ADRs occurring during admission. Review of the data base for a two-year period disclosed 162 well-documented ADRs, many times greater than those generated in FDA reports. The patterns of ADRs found, actions taken in response, and strengths and limitations of this system for ADR screening are reviewed. This semispontaneous screening and reporting method is found to be a valuable tool for a local hospital's ADR program, with great potential for involving physicians and providing local feedback on ADR rates.