Medication Safety: The “Other” Healthcare Reform Movement
May/June 2011
Medication Safety
The “Other” Healthcare Reform Movement
While most mainstream media coverage in recent months has framed discussions of healthcare reform around issues of access and cost management, there is an equally critical type of healthcare reform evolving within hospitals that impacts nearly every patient—improving medication safety. While it is undeniably a question of enhancing patient safety, there are strong economic motivators behind these initiatives as well.
Ten years ago, the median compensation award for medication errors was a staggering $668,000, a figure that most assuredly skyrocketed during the last decade. Additionally, each adverse drug event (ADE)—the profession’s language for drug-driven harm to the patient—costs the hospital an average $8,750 to treat, a significant amount that cannot be billed to the patient’s insurance provider. With 4 out of 10 medical errors in U.S. hospitals related to medication mismanagement, such hits to the already strained bottom lines of U.S. hospitals are causing more and more hospitals to question their own medication safety practices.
More often than not, increased reliance on technology is seen as the primary action for improving medication safety. Yet the sizable investment required by many technology solutions can also be the core reason why cash-strapped hospitals and care facilities postpone implementation.
Truth be told, however, better technology is only half the solution; the “people” component is equally important.
Improving Medicine Safety Step by Step
Studies indicate that more than half the medication errors that reach the patient occur in the last 100 feet to the bedside. Not surprising, institutions currently leading the safer medicines movement literally walk that distance in the shoes of their doctors and staff to better understand the daily challenges they confront, directly and indirectly, to get the right medication in the right dose to the right patient at the right time.
Limited resources, increased workloads, sicker patients, new technologies that require training and process design, evolving regulatory requirements and practice variation are among the most common underlying causes for ADEs. To devise meaningful safe medication practices, it is imperative that hospital administrators and their risk management teams first understand the medication process as it unfolds on their units rather than simply in the ideal world of a procedures manual. Only by doing so can they truly understand how and where human error transpires.
Having walked numerous hospital hallways step-by-step with their multidisciplinary teams to identify opportunities to streamline their drug dispensing and administration processes, there are certain things that forward-thinking hospitals consistently do right from the “people” perspective. Chief among them:
- Adopt a holistic approach. Safe medication practices require more than sound policy. They require a safety culture. As such, mitigating an institution’s medication-related risks should not be delegated to one administrative function or medical team for oversight. Nor should one group be held solely accountable.
- Appoint an executive sponsor. While cultivating a medication safety culture requires multidisciplinary participation and dedication, it also requires an executive-level sponsor to initiate that first step. The executive sponsor plays a critical role in championing the cause and acting as the internal voice of change.
- Identify and engage committed front-line ambassadors to “walk the talk” on medication safety. Forward-thinking companies facing organizational change recognize that introducing new practices and philosophies requires more than solid, committed leaders to spread the messages in meaningful ways. It also requires fully engaged staffers outside the C-suite to cascade those messages throughout the organization and help implement them.
- Foster a more collaborative relationship between the pharmacy and nursing functions that reflects their shared responsibility in delivering safe medications to patients. Once a medication enters the hospital system, there are two primary functions that are responsible for its physical handling – pharmacy and nursing. Consequently, it is imperative that both teams work as a unified force in driving safety improvements.
- Appropriate and safeguard a dedicated budget that reflects the critical importance of maintaining a culture of safer medications. Organizational change does not come easily, quickly, or without cost. It requires a long-term commitment of people and financial resources to diligently, continuously push safe medicine standards. A one-time special project allocation cannot deliver sustainable, meaningful change.
By streamlining and optimizing the processes by which medication-related tools and technologies are used, patient safety-oriented hospitals are reporting not only fewer mistakes, but also staff productivity and performance gains, more consistency in medication outcomes, reductions in medicine shrinkage, and realized cost savings from the decreases in ADEs.
Decreased costs and better patient outcomes? Now that’s an easy pill to swallow.
Susan Stinson is vice president and clinical practice lead at AmerisourceBergen. She may be contacted at sstinson@amerisourcebergen.com.