Affiliations 

  • 1 Pharmacy Department, Raja Permaisuri Bainun Hospital; &. Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia. Penang (Malaysia). [email protected]
  • 2 Pharmacy Department, Raja Permaisuri Bainun Hospital. Perak (Malaysia). [email protected]
  • 3 Pharmacy Department, Raja Permaisuri Bainun Hospital. Perak (Malaysia). [email protected]
  • 4 Discipline of Social & Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia. Penang (Malaysia). [email protected]
  • 5 Center for Clinical Epidemiology, Institute for Clinical Research, National Institutes of Health, Ministry of Health. Selangor (Malaysia). [email protected]
  • 6 Pediatric Department, Raja Permaisuri Bainun Hospital, Ministry of Health. Perak (Malaysia). [email protected]
Pharm Pract (Granada), 2019 08 21;17(3):1501.
PMID: 31592290 DOI: 10.18549/PharmPract.2019.3.1501

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.