Hospital executives need to continue the quest to improve quality and reduce the number of medical errors. At stake are the reputations, credibility and possibly the survival of many healthcare organizations.
Most managers would be proud if their hospitals eliminated half of the clinical mishaps, but the industry is wise to rally around a zero-tolerance level for errors. But there are no off-the-shelf answers, no bubble-wrapped panaceas.
Information technology can help streamline the process, but it is only a tool. Measurable change requires ample risk, heavy investment, time-consuming staff training and committed leadership. The quality-improvement agenda begins with building a corporate culture that encourages the reporting and study of outcomes and errors. Next comes a buy-in from clinicians to follow recognized standards of care and treatment protocols. Improved communications also will reap benefits. And as providers work to comply with the Health Insurance Portability and Accountability Act of 1996, they should strive to standardize the exchange of patient information and eliminate the sloppy handoffs that can lead to errors.
In the short term, quality gurus believe that automated medication order-entry systems can dramatically reduce one of the most common medical errors-adverse drug events. Although computerized order entry is a wonderful thing, there are challenges to making it work to full potential. At the risk of dousing enthusiasm, let's remember a few things.
* Although a number of promising and viable order-entry systems are on the market, none has emerged as an industry standard.
* Most of the products are deemed too expensive for cash-starved hospitals. The federal Agency for Healthcare Research and Quality says only about 13% of hospitals have systems that let clinicians enter and monitor prescriptions electronically.
* Resistance from physicians and lack of training may mean the automated systems aren't used properly, if at all.
These are just some pieces of a puzzle that hasn't quite fit together, but they illustrate the hard work that lies ahead.