Enhancing Drug Hypersensitivity Reaction Documentation Through a Clinical Surveillance Tool.

Area of Science:

• Clinical Pharmacy
• Patient Safety
• Health Informatics

Background:

• Drug hypersensitivity reactions (DHRs) are serious immune responses to medications.
• Accurate documentation of DHRs in electronic health records (EHRs) is vital for patient safety.
• A significant underdocumentation of DHRs (25.6%) was identified in a Veterans Affairs emergency department (ED).

Purpose of the Study:

• To implement a quality improvement (QI) project to increase DHR documentation rates.
• To achieve a target DHR documentation rate of ≥ 50% within 6 months.
• To utilize a clinical surveillance tool to enhance DHR reporting.

Main Methods:

• A pharmacist-led QI project was conducted in a single VA ED.
• A clinical surveillance tool was implemented to monitor and improve DHR documentation.
• DHR documentation rates were measured monthly using defined metrics.
• Statistical Process Control (SPC) with Exponentially Weighted Moving Averages (EWMA) was employed for analysis.

Main Results:

• The DHR documentation rate increased from 25.6% to 65.4% over 6 months.
• The intervention successfully surpassed the target goal of 50% documentation.
• EWMA SPC analyses demonstrated a sustained improvement in documentation rates.

Conclusions:

• A pharmacist-led QI initiative effectively improved DHR documentation in an ED setting.
• Clinical surveillance tools represent a low-cost, feasible solution for enhancing DHR reporting.
• Improved EHR documentation of DHRs enhances patient safety by alerting healthcare teams to drug risks.