Training medical staff to audit small numbers of patient charts can have a significant impact on reducing adverse drug events at a low cost, new research suggests.
By examining 2,837 charts from 86 hospitals--documenting more than 268,000 separate medication doses-- researchers at the Institute of Healthcare Improvement and hospital purchasing cooperative Premier were able to identify 720 adverse drug events, or 2.68 ADEs per 1,000 doses.
Traditional means of identifying ADEs might turn up less than 2% of this total, the researchers write in the June issue of the bimonthly journal Quality and Safety in Health Care.
The study puts a low-technology spin on a decade-old idea of employing "trigger tools" to catch medication errors. University of Utah medical informaticist David Classen, M.D., first described in 1991 how the ordering of certain drugs could trigger a detailed audit of electronic medical records to determine if the order could cause harm to patients.
However, the Boston-based IHI and researchers at San Diego-based Premier researchers began a search four years ago for a more practical way of identifying potential ADEs, since EMRs are not yet in widespread use and because a lack of standards makes benchmarking between institutions costly and unreliable.
The IHI publishes the quality journal in conjunction with BMJ Publishing Group, publisher of the British Medical Journal.