Bringing a pharmacist along on rounds in the intensive-care unit can sharply reduce the rate of preventable adverse drug events related to drug ordering, a study in the Journal of the American Medical Association reported last week.
Without the pharmacist's participation, preventable adverse drug events (ADEs) were 10.4 per 1,000 ICU patient days; involving the pharmacist brought that figure down to 3.5 per 1,000 patient days, a drop of 66%.
This study is the latest in a series from a Boston research team that's trying to reduce medical errors by changing the systems under which hospital practitioners operate.
The study's lead author, Lucian Leape, M.D., a professor at the Harvard School of Public Health, said prescribing errors are the leading cause of patient injuries in hospitals. Five other researchers associated with Massachusetts General Hospital and Brigham and Women's Hospital, both in Boston, co-authored the paper.
The authors used the ICU at Massachusetts General for their study. After first establishing baseline rates of ADEs, they assigned a pharmacist to make rounds with residents, nurses, and attending staff each morning and to consult on-call throughout the day. This took about half the pharmacist's time. In the control group, there was no pharmacist on rounds.
They estimated the financial impact of the averted drug errors at $270,000 a year at Massachusetts General. In 1995, they said, 58 errors were prevented, at a cost of $4,685 each.
Rie said more study is needed before hospital administrators assign pharmacists to make ICU rounds. But it's not too early, he suggested, to begin incorporating data on negative outcomes into hospital accreditation and payment methodologies.
