Premium
Does an Electronic Discharge Referral System Improve the Quality of Medication Prescribing?
Author(s) -
Garrett Tim,
McCormack Claire
Publication year - 2014
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2014.tb00013.x
Subject(s) - medicine , audit , referral , electronic prescribing , medical prescription , emergency medicine , legibility , patient safety , quality management , observational study , medical emergency , family medicine , health care , nursing , operations management , art , management system , management , economics , visual arts , economic growth
Background Unintentional discrepancies in medication lists at the time of discharge are common and a significant cause of avoidable harm. Electronic discharge referral (eDR) systems represent an opportunity to reduce the risk of harm. However, there are few Australian studies describing this approach. Aim To investigate the impact of an eDR system on the quality of medication prescribing. Method A prospective, observational study of discharge medication orders was undertaken in a 520‐bed principal referral hospital. A structured audit tool was used to assess the quality (volume, type and severity) of prescribing errors on patients' discharge summaries for 2 weeks immediately before the implementation of the eDR system (pre‐eDR) and re‐audited 6 weeks after implementation (post‐eDR). Results Discharge summaries from 776 patients were evaluated (n = 377 pre‐eDR (handwritten process); n = 399 post‐eDR (electronic process)). The number of discharges with one or more prescribing errors decreased significantly after implementation of the eDR system (relative difference −39.6%; P < 0.001), including errors relating to: supply quantities ( P < 0.001), legibility ( P < 0.0001), drug selection ( P = 0.009), prescription format selection ( P = 0.026), patient details ( P = 0.039) and signing of orders ( P = 0.007). However, no significant difference was observed in the overall mean severity score for errors between the electronic and handwritten discharge processes (3.5 vs 3.4; P = 0.28). Conclusion Implementation of an eDR system resulted in an improved quality and potential safety of patients' discharge medication orders. However, despite a reduced frequency of errors, the emergence of new error types was observed, and the profile and overall severity of prescribing errors remained unchanged.