Changes in Medication Errors after Implementation of an Electronic Health Record System in a Canadian Community...

The introduction of electronic health records (EHRs) and computerized physician order entry has been associated with a reduction in medication errors due to the safety features of these systems.

To identify changes in medication errors-specifically related to the types and severity of errors documented and the numbers and types of errors by clinical program-before and after implementation of an EHR system and to identify medication safety initiatives.

This retrospective observational study was conducted at a 2-campus, 500-bed Canadian community hospital before (April 10, 2019, to April 10, 2021) and after (April 11, 2021, to April 11, 2023) implementation of an EHR system. Data were categorized according to event type to ascertain changes in types of errors before and after EHR implementation by clinical program. Data were also collected to determine changes in the severity of errors, as well as changes in categories and changes in frequency of event types (e.g., barcode scanning, medications not ordered, incorrect orders).

Totals of 1379 and 1269 medication errors were reported before and after EHR implementation, respectively. The reduction in frequency of errors was statistically significant (z score = 2.14). Overall, statistically significant reductions were observed for errors that did not reach the patient and for errors that reached the patient and necessitated increased monitoring. There were statistically significant decreases in errors secondary to medication(s) not being ordered (197 before vs 121 after EHR implementation) and medications being administered to the incorrect patient (58 vs 20, respectively).

Implementation of the EHR system was associated with a reduction in overall medication incidents at the study institution. Findings from this study allowed the medication safety committee to identify targeted medication safety initiatives focused on barcode scanning (of both medications and patient identification) to reduce the frequency of patients receiving incorrect medications.