PATIENT SAFETY FOCUS
Findings Show eMAR Reduces Errors
BWH administers a dose of medication every five seconds. That’s 6.2 million doses per year, making the electronic medication administration system crucial to patient safety.
eMAR—which electronically links physicians writing prescriptions, pharmacists reviewing orders and nurses administering them has reduced significantly the number of medication errors. Targeted pharmacy dispensing errors have been reduced by 85 percent, and potential adverse events by about 63 percent. Jennifer Cina, PharmD, and Tejal Gandhi, MD, MPH, and several of their BWH colleagues detailed these findings in the February 2006 Joint Commission Journal on Quality and Patient Safety.
Last month, BWHers from Pharmacy, Nursing, hospital leadership and IS gathered to celebrate the system’s successes at a reception in the PBB Rotunda.
BWH began developing its seamless electronic medication administration system in 2001. Without available commercial products to suit its needs, the hospital forged its own path and designed a new system, including a pharmacy system to drive the entire process and a drug repackaging center. “What separates us from other hospitals is the ability to be innovative and creative and design for the future—not where we want to be now, but five to ten years from now and beyond,” Bill Churchill, MS, RPh, director of Pharmacy, said.
In designing the bar-coding system, BWH examined best practices both within and outside the health care industry. For example, the adoption of a two-dimensional bar code similar to what Fed Ex uses allows the pharmacy to store more information, including the drug expiration date. These bar codes proved critical to avoiding medication errors, and today, many drug manufacturers are seeking BWH’s input in bar coding their drugs.
The combination of bar code technology and the electronic medication administration record is promising for reducing administration errors by nurses.
Going forward, the Medication Administration Team is attempting to implement eMAR in procedural areas like the OR and the PACU, and examining new technology to determine whether it will benefit patient safety at BWH.