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Electronic medication reconciliation and medication errors
Jonathan D Hron1, Shannon Manzi2, Roger Dionne2
1Department of Medicine, Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA.
Insights
Implementing an electronic medication reconciliation tool reduced hospital admission medication errors by 53%. This quality improvement project highlights the effectiveness of digital tools in enhancing patient safety and reducing adverse drug events.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety
- Health Informatics
Background:
- Medication errors during hospital admissions pose a significant risk to patient safety.
- Accurate medication reconciliation is crucial for preventing adverse drug events.
Purpose of the Study:
- To evaluate the impact of implementing an electronic medication reconciliation tool on the incidence of admission medication reconciliation errors (MREs).
Main Methods:
- A quality improvement project utilizing a time-series design was conducted at a large, urban, tertiary care children's hospital.
- The study included all admitted patients from 2011 and 2012.
- An electronic tool was implemented to facilitate side-by-side comparison of pre-admission and admission medication orders, with regular compliance reporting.
Main Results:
- Over 33,000 admissions were analyzed, with 84% utilization of the electronic tool post-intervention.
- A total of 146 MREs were reported, including 95 non-intercepted errors.
- The rate of non-intercepted errors decreased by 53% (P = 0.02) post-implementation, with no reported major or catastrophic adverse drug events.
Conclusions:
- Successful implementation of an electronic medication reconciliation process was achieved.
- The electronic tool was associated with a significant reduction in reported non-intercepted admission MREs.
- This demonstrates the potential of health informatics tools to improve medication safety in pediatric care.
Objective:
To measure the impact of electronic medication reconciliation implementation on reports of admission medication reconciliation errors (MREs).
Design:
Quality improvement project with time-series design.
Setting:
A large, urban, tertiary care children's hospital.
Participants:
All admitted patients from 2011 and 2012.
Interventions:
Implementation of an electronic medication reconciliation tool for hospital admissions and regular compliance reporting to inpatient units. The tool encourages active reconciliation by displaying the pre-admission medication list and admission medication orders side-by-side.
Main Outcome Measure:
Rate of non-intercepted admission MREs identified via a voluntary reporting system.
Results:
During the study period, there were 33 070 hospital admissions. The pre-admission medication list was consistently recorded electronically throughout the study period. In the post-intervention period, the use of the electronic medication reconciliation tool increased to 84%. Reports identified 146 admission MREs during the study period, including 95 non-intercepted errors. Pre- to post-intervention, the rate of non-intercepted errors decreased by 53% (P = 0.02). Reported errors were categorized as intercepted potential adverse drug events (ADEs) (35%), non-intercepted potential ADEs (42%), minor ADEs (22%) or moderate ADEs (1%). There were no reported MREs that resulted in major or catastrophic ADEs.
Conclusions:
We successfully implemented an electronic process for admission medication reconciliation, which was associated with a reduction in reports of non-intercepted admission MREs.
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