AMA, JCAHO list ways to avoid med errors
As part of their recent push to address clinical errors, the American Medical Association and the Joint Commission on the Accreditation of Healthcare Organizations are offering solutions to some of the most common medical problems. At a joint meeting in Rancho Mirage, CA, on Oct. 13, 1996, Lucian Leape, MD, adjunct professor of health policy at the Harvard School of Public Health in Boston, addressed medication errors.
Leape is a pediatric surgeon and frequent speaker on error prevention. He suggests following these 10 tips to avoid medication errors:
1. Move rapidly to electronic medical records and computerized physician ordering, eliminating handwritten medical records and physician orders.
2. Institute fail-safe tracking of medications to ensure that the right medication gets to the right patient at the right time. Do the same for laboratory tests.
3. Expand the use of protocols and guidelines to ensure that the best practices are standardized and carried out.
4. Maintain the practice of unit dosing for medications, in which each medication dose for each patient is prepared in the pharmacy.
5. Standardize the dose strengths of each medication, as well as times of medication administration, protocols for use of hazardous drugs, medication terminology, and the names of drugs.
6. Make it difficult or impossible for a person to make some errors by "error proofing" procedures. An example is the way oxygen and nitrous tanks have different connections to anesthesia machines so that one will not fit the other. Look for ways to apply the same thinking to drug administration.
7. Implement bar coding of medications and patients so that both are positively identified before a drug is administered.
8. Involve pharmacists directly in health care on the nursing unit level.
9. Involve patients in the care process wherever possible, ensuring they understand all the medications, treatments, and tests they are to receive so they can be active partners with physicians and nurses in preventing errors by verifying that they are getting the right medications and other treatments. Allow patients to self-administer pain medications when possible.
10. Apply information management technology to patient management as aggressively as it is currently applied to financial management.
For more information, contact Lucian Leape, MD, adjunct professor of health policy, Harvard School of Public Health, Building 3, Fourth Floor, 677 Huntington Ave., Boston, MA 02115. Telephone: (617) 432-2008.
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