MEDICATION ERRORS: Reduced 66% with Pharmacist’s Input
Adding pharmacists to the team of providers conducting hospital rounds "may cut hospital medication errors by as much as two- thirds," according to a study conducted at Massachusetts General Hospital (MGH) and published in today's issue of the Journal of the American Medical Association, the Boston Globe reports. Dr. Lucian Leape, adjunct professor of health policy at the Harvard School of Public Health, said, "The most common cause of accidental injury to patients in hospitals is prescribing error" -- harming between 770,000 and 2 million U.S. hospital patients annually, but preventable in more than a quarter of cases (Kong, 7/21). During the study, a pharmacist devoted a half-day to accompanying physicians for 10 months and "intervened in 398 cases of problem prescription, 99% of which were due to doctor error." Errors included "incomplete medication, incorrect dosage or frequency and inappropriate drug choice," -- all of which were attributed to a lack of information on patients and drugs. Pharmacists also identified 47 cases in which a cheaper or safer drug could be substituted (Reuters/New York Times, 7/21). The inclusion of a pharmacist in MGH's intensive care unit reduced error from 10.4 per 1,000 patient days to 3.5 per 1,000 patient days. Leape noted, "My own feeling is that the pharmacist is the most underutilized resource in the hospital." Errors cost about $4,685 each, and the estimated 58 errors prevented at MGH saved $270,000. Harold DeMonaco, director of drug therapy at MGH and one of the paper's authors, said, "Pharmacists tend to be somewhat expensive personnel, but there is a very adequate return on investment -- multiples of the pharmacist's salary." Since the study, MGH has hired more than six additional pharmacists and installed a computer medication- order system that reduced medication errors by 50% at its sister hospital, Brigham and Women's (Globe, Kong, 7/21).
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