Cost-Benefit Analysis of the Detection of Prescribing Errors by Hospital Pharmacy Staff

Bemt, Patricia M. L. A. van den; Postma, Maarten J.; Roon, E.N. Van; Chow, M; Fijn, Roel; Brouwers, Jacobus

doi:10.2165/00002018-200225020-00006

Cited by 57 publications

(41 citation statements)

References 20 publications

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“…Dosing mistakes are the most common preventable medication error that may lead to an ADE 2,[17][18][19][24][25][26][27]29 and were found to be responsible for over one third of the clinically significant prescribing errors in this study. In addition, they accounted for 4 of the 7 most serious errors that were rated as having the potential to lead to permanent patient harm.…”

Section: Epidemiology Of Prescribing Errorsmentioning

confidence: 94%

The Epidemiology of Prescribing Errors

Bobb¹,

Gleason²,

Hüsch³

et al. 2004

Arch Intern Med

302

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Section: Epidemiology Of Prescribing Errorsmentioning

confidence: 94%

The Epidemiology of Prescribing Errors

Bobb¹,

Gleason²,

Hüsch³

et al. 2004

Arch Intern Med

302

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“…It is estimated that medication errors occur in 57 per 1000 orders, with 18.7 – 57.7% of these errors having the potential for harm [2]. The suggestion that detection of preventable errors by health care professionals could improve patient safety and reduce the cost of adverse drug events [3], has been sufficient to spawn a multitude of medication safety initiatives with limited rigorous evaluation of their benefits and harms. Although they have several uses, the main interest in electronic health records (EHR) and computerized decision support systems (CDSS) is to improve patient outcomes by influencing the decision making process of providers [4-6].…”

Section: Introductionmentioning

confidence: 99%

Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials

Mollon

Chong

Holbrook

et al. 2009

BMC Med Inform Decis Mak

107

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BackgroundComputerized decision support systems (CDSS) are believed to have the potential to improve the quality of health care delivery, although results from high quality studies have been mixed. We conducted a systematic review to evaluate whether certain features of prescribing decision support systems (RxCDSS) predict successful implementation, change in provider behaviour, and change in patient outcomes.MethodsA literature search of Medline, EMBASE, CINAHL and INSPEC databases (earliest entry to June 2008) was conducted to identify randomized controlled trials involving RxCDSS. Each citation was independently assessed by two reviewers for outcomes and 28 predefined system features. Statistical analysis of associations between system features and success of outcomes was planned.ResultsOf 4534 citations returned by the search, 41 met the inclusion criteria. Of these, 37 reported successful system implementations, 25 reported success at changing health care provider behaviour, and 5 noted improvements in patient outcomes. A mean of 17 features per study were mentioned. The statistical analysis could not be completed due primarily to the small number of studies and lack of diversity of outcomes. Descriptive analysis did not confirm any feature to be more prevalent in successful trials relative to unsuccessful ones for implementation, provider behaviour or patient outcomes.ConclusionWhile RxCDSSs have the potential to change health care provider behaviour, very few high quality studies show improvement in patient outcomes. Furthermore, the features of the RxCDSS associated with success (or failure) are poorly described, thus making it difficult for system design and implementation to improve.

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“…Since then, numerous studies have documented and analysed errors in prescribing (e.g. Dean et al 2002, Van den Bemt et al 2002, preparing and dispensing (e.g. Rolland 2004, Ashcroft et al 2005 or administering (for a review, see O'Shea 1999, Armitage and Knapman 2003) medication.…”

Section: Introductionmentioning

confidence: 99%

Error recovery in a hospital pharmacy

et al. 2006

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A field study was performed in a hospital pharmacy aimed at identifying positive and negative influences on the process of detection of and further recovery from initial errors or other failures, thus avoiding negative consequences. Confidential reports and follow-up interviews provided data on 31 near-miss incidents involving such recovery processes. Analysis revealed that organizational culture with regard to following procedures needed reinforcement, that some procedures could be improved, that building in extra checks was worthwhile and that supporting unplanned recovery was essential for problems not covered by procedures. Guidance is given on how performance in recovery could be measured. A case is made for supporting recovery as an addition to prevention-based safety methods.

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Cost-Benefit Analysis of the Detection of Prescribing Errors by Hospital Pharmacy Staff

Abstract: From this study it can be concluded that prevention of prescribing errors by hospital pharmacy staff results in higher benefits than the costs related to the net time investment.

Cited by 57 publications

References 20 publications

The Epidemiology of Prescribing Errors

The Epidemiology of Prescribing Errors

Features predicting the success of computerized decision support for prescribing: a systematic review of randomized controlled trials

Error recovery in a hospital pharmacy

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