By Karen Scoles, M.D., Medical Director of Information Systems
Crozer-Keystone Health System is on a journey to safer, more effective care using health information technology. An important step on this journey is ensuring accurate, efficient delivery of medication to patients in need. It has been estimated that there are 1.5 million preventable adverse drug events annually. Information technology is consistently identified as an important component of patient safety strategies to reduce these adverse drug events.
We use a closed-loop medication administration system to electronically track medications through four key stages of treatment: ordering, transcription, dispensing and administration.
Computerized provider order entry (CPOE) offers opportunities to reduce medication errors when physicians or providers order medication. With CPOE, physicians and other licensed providers write the orders in the system supported by clinical decision support tools to guide and validate orders.
The immediate benefit is decreased errors related to misinterpretation of handwriting. Additional benefits include:
- Decreased time to care
- Decreased costs by reducing duplicates
- Improved compliance with guidelines by the use of best practice order sets
- Better outcomes
When pharmacists enter orders for medication, using electronic medication administration prevents transcription errors, or errors related to handwriting interpretation.
An important component of closed-loop administration is medication dispensing using barcode products from the Pharmacy. This complex process is now supported in the Crozer-Keystone hospital pharmacies by the latest automated technology, which uses barcodes and “pick to light” technology to ensure accurate dispensing.
All Crozer-Keystone hospitals use Medication Administration Check (MAK), a tool that uses bar-code scanners at the bedside to administer medications by nursing or respiratory therapists to patients. Bar-coded medication administration is a key feature of closed-loop medication administration and has been demonstrated to prevent medication administration errors by ensuring the “Five Rights” of medication administration: the right patient, the right medication, the right dose, the right route and at the right time.
Less than 30% of U.S. hospitals are using bar coding and CPOE technologies today. For those who have implemented this technology, the results are significant. Hospitals that adopted electronic medication administration records and CPOE performed better on medication quality measures related to conditions including acute myocardial infarction (MI), heart failure and pneumonia. These hospitals were also more likely to offer appropriate medications to patient’s undergoing surgery.
In 2014 all Crozer-Keystone hospitals, Crozer-Chester Medical Center, Delaware County Memorial Hospital, Springfield Hospital and Taylor Hospital are using these technologies to improve the care of hospitalized patients.