Three health systems recognized for drug safety

December 12, 2005

A pharmacist-led multidisciplinary team at Evanston (Ill.) Northwestern Healthcare (ENH) has earned for the health system the 2005 Award for Medication-Use Safety.

A pharmacist-led multidisciplinary team at Evanston (Ill.) Northwestern Healthcare (ENH) has earned for the health system the 2005 Award for Medication-Use Safety.

ENH created a completely electronic health record system for use in an acute care and ambulatory setting. The facility implemented the system in its three hospitals and 65 physician offices, requiring every physician and clinician to use it. It improved patient safety by eliminating problems due to illegible orders; providing accessibility to the right patient data for all physicians, clinicians, and administrators; and ensuring that the information and coded data in the record are accurate. Since implementing the electronic record, ENH has eliminated 100% of all transcription-related errors and has seen a 70% decrease in delayed administration of medications to patients, a 20% decrease in omitted medication administration, and a 50% reduction in time from order to administration of first-dose antibiotics.

The group did not plan extensively or initiate a pilot rollout; rather, "we just did it," said Lynn Boecler, Pharm.D., M.S., senior director of pharmacy services for ENH and the pharmacist who led the multidisciplinary team in its initiatives. The time frame from initial planning to the go-live date at ENH's first hospital was about 18 months.

The safety award, bestowed by the ASHP Research & Education Foundation, recognizes pharmacy professionals who have assumed a leadership role in promoting medication-use safety and achieving institutionwide medication-use improvements. It is sponsored by the Cardinal Health Foundation, the community relations arm of Cardinal Health that funds regional and national healthcare quality improvement projects.

"We are pleased that the ASHP and Cardinal Health foundations recognized the tremendous amount of work required to accomplish these outcomes," stated Boecler. ENH will receive a $50,000 award to be used to further promote medication-use safety within its system.

Despite the success and recognition of ENH's electronic record, Boecler insists that there is work yet to be done. "We now know that the system is able to perform these tasks and demonstrate these outcomes, but this is only the first step," she said. "Now that the data are captured, we can use them to provide better direct care of our patients."

Two other institutions were also honored: St. Francis Hospital & Health Centers, Beech Grove, Ind., and Sutter Medical Center Sacramento (SMCS), in California. Both facilities will receive a $10,000 award.

St. Francis commissioned a Medication Event Decision Support (MEDS) team to develop a strategic plan for medication safety. The team built a "culture of safety" at St. Francis, promoting a nonpunitive environment for sharing information and lessons learned, developing a safety reporting system, and fostering multidisciplinary teamwork. It instituted a zero-tolerance policy for abbreviations related to insulin orders and determined new ways to use existing technology to improve medication safety and communications.

SMCS developed an Emergency Drug Sheet System to define all concentrations of vasoactive medications and standardize procedures for all aspects related to medication use, including prescribing, preparing, administering, dispensing, and storing. A software program prints a single-page, patient-specific reference sheet. Used by all clinicians for all patients in the hospital, it eliminates manual mathematical calculations-a major source of error and delay-from the prescribing, preparation, and administration steps in the medication-use process. It can be printed from any patient care computer by entering a patient name and weight, ensuring faster, safer preparation and delivery of vasoactive medications for neonatal and pediatric patients.

"It is remarkable to see the systems improvement and the advances for patients' medication safety achieved by the practitioners at these sites," said Stephen J. Allen, M.S., FASHP, executive VP and CEO of the ASHP Foundation. "Pharmacist leadership was instrumental in every case, with tremendously valuable and transferable lessons to be learned." Finalists were chosen based on achievement in medication-use system initiative/scope, planning and implementation, measurable outcomes and impact; and innovation and applicability.

The Author is a writer residing in the Atlanta area.