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Dual HIT Programs Reduce Medication Errors at Hopkins

John Commins, for HealthLeaders Media, March 23, 2011

Coupling electronic prescription drug ordering with computer reporting of adverse events can dramatically reduce medication errors in psychiatric units, Johns Hopkins researchers say.

"Medication errors are a leading cause of adverse events in hospitals," says study leader Geetha Jayaram, MD, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. "With the use of electronic ordering, training of personnel and standardized information technology systems, it is possible to eliminate dangerous medication errors."

The findings, published in the March issue of The Journal of Psychiatric Practice, detail how the 88-bed psychiatric unit at The Johns Hopkins Hospital in Baltimore went from a medication error rate of 27.89 per 1,000 patient days in 2003 to 3.43 per 1,000 patient days in 2007. During the study period there were no medication errors that caused death or serious, permanent harm, the study said.

Potentially lethal medication errors can be caused by illegible handwriting, misinterpretation of orders, caregiver fatigue, pharmacy dispensing errors and administration mistakes. "Having something typed eliminates bad writing — and most errors — immediately," Jayaram said. "It's a good reason for going electronic."

The computer program used in the psychiatric department, and hospital-wide at Johns Hopkins, includes integrated decision support for drug dosage selection, drug allergy alerts, drug interactions, patient identifiers and monitoring — data that can be lost with a manual system that relies on layers of human beings, Jayaram said, adding that the more the number of steps involved in the process, the greater the likelihood of mistakes.

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