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Impact of a S wiss adverse drug event prevention collaborative
Author(s) -
Staines Anthony,
Mattia Costanza,
Schaad Nicolas,
Lécureux Estelle,
Bonnabry Pascal
Publication year - 2015
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12376
Subject(s) - medicine , cohort , adverse effect , pill , emergency medicine , drug , psychological intervention , cohort study , pediatrics , pharmacology , psychiatry
Rationale, aims and objectives The H ospital F ederation of V aud ( S witzerland) used a B reakthrough C ollaborative with the aim of reducing adverse drug events ( ADEs ) by 20% in 10 participating hospitals. Methods A set of interventions (covering patient identification, high‐alert medication and medication preparation in the ward) was deployed over 18 months starting in O ctober 2010. All hospitals monitored discrepancies between drugs prescribed and those prepared for administration, as well as the occurrence of ADEs using the ADE T rigger T ool for 18 months (cohort 1). A subset of five hospitals continued this monitoring for 12 additional months (cohort 2). Results In cohort 1, pill box discrepancies were present in 5.9% of doses ( n = 9772) in 2011 and in 5.8% ( n = 2251) in the first 3 months of 2012 (no statistical significance). There were no significant differences in the rate of ADEs /1000 doses across time (1.2 in 2010, 1.0 in 2011 and 1.0 in 2012). In cohort 2, pill box discrepancies were reduced from 6.5% ( n = 4846 doses) in 2011 to 4.4% ( n = 7355) in 2012 ( P < 0.001) to 3.0% for the first 3 months of 2013 ( n = 2251; P = 0.004). The rate of ADEs /1000 doses decreased (1.8 in 2010, 1.1 in 2011 and 0.6 in 2012/13 ( P = 0.008 for 2010–2011, and P < 0.001 for 2011–2012/2013). Conclusions Reductions in drug discrepancies and ADEs occurred in the cohort with the longer monitoring duration. Factors contributing to success may include the strategic status of the project, executive support, perseverance in post‐intervention measurement, and institution‐wide rather than partial deployment.