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Effectiveness of a pharmacist-led quality improvement program to reduce medication errors during hospital discharge

Doris George1,2★, Nirmala Devi Supramaniam1, Siti Qurasyiah Abd Hamid1, Mohamad Azmi Hassali2, Wei-Yin Lim3, Amar-Singh Hss4★ Corresponding author

  1. 1Pharmacy Department, Raja Permaisuri Bainun Hospital. Perak, Malaysia.
  2. 2Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia. Penang, Malaysia.
  3. 3Center for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health. Selangor, Malaysia.
  4. 4Pediatric Department, Raja Permaisuri Bainun Hospital, Ministry of Health. Perak, Malaysia.

CORRESPONDENCE

Doris George

Pharmacy Department, Raja Permaisuri Bainun Hospital; & Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.

doris.moh.gov@gmail.com

Received: 20-03-2019; Accepted: 05-08-2019.

Volume 17, Issue 3 · pp. 1501 · PUBLISHED Jul-Sep 2019 · DOI: 10.18549/PharmPract.2019.3.1501

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ABSTRACT

Background: Patients requiring medications during discharge are at risk of discharge medication errors that potentially cause readmission due to medication-related events. Objective: The objective of this study was to develop interventions to reduce percentage of patients with one or more medication errors during discharge. Methods: A pharmacist-led quality improvement (QI) program over 6 months was conducted in medical wards at a tertiary public hospital. Percentage of patients discharge with one or more medication errors was reviewed in the pre-intervention and four main improvements were developed: increase the ratio of pharmacist to patient, prioritize discharge prescription order within office hours, complete discharge medication reconciliation by ward pharmacist, set up a Centralized Discharge Medication Pre-packing Unit. Percentage of patients with one or more medication errors in both pre- and post-intervention phase were monitored using process control chart. Results: With the implementation of the QI program, the percentage of patients with one or more medication errors during discharge that were corrected by pharmacists significantly increased from 77.6% to 95.9% (p<0.001). Percentage of patients with one or more clinically significant error was similar in both pre and post-QI with an average of 24.8%. Conclusions: Increasing ratio of pharmacist to patient to complete discharge medication reconciliation during discharge significantly recorded a reduction in the percentage of patients with one or more medication errors.

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    George, D., Supramaniam, N. D., Hamid, S. Q. A., Hassali, M. A., Lim, W., & Hss, A. (2019). Effectiveness of a pharmacist-led quality improvement program to reduce medication errors during hospital discharge. Pharmacy Practice, 17(3), 1501. https://doi.org/10.18549/PharmPract.2019.3.1501