By Bill Hendrick
Piedmont Hospital is embarking on a pilot study aimed at finding ways to reduce the number of life-threatening mistakes that are made when health care workers interview patients about the medications they take.
It’s a national problem, and national studies have found that discrepancies are prevalent in medical histories taken at the time of patient admission. At least one medication discrepancy is found in up to 67 percent of inpatients nationally, though the frequency at Piedmont is about 40 percent.
The study at Piedmont and 34 other health organizations is aimed at finding ways to ensure that more accurate, complete medical information is collected from patients.
Dr. Matthew Schreiber, medical director for hospitalist services at Piedmont Healthcare and interim chief medical officer at Piedmont Hospital, said inaccurate patient information is a major cause of health problems across the nation. Such errors can cause deaths and are a significant liability expense for health care providers.
“National studies have shown the accuracy of information is poor,” Schreiber said. “Many patients don’t know what they are taking, or they may forget to tell the nurse what they are taking. Patients often do not mention the over-the-counter medications they are using.”
He said Piedmont will receive $35,000 from the Cardinal Health Foundation for the study. The money will test a more resource-intensive process of having a pharmacist gather medication information from patients.
“Since the pharmacist will be dedicated to the 20-bed unit, he or she will have the time to ask questions that will get to the truth of what the patients are taking,” Schreiber said.
The pilot program is an experiment he said he hopes will lead to more pharmacists being hired to assume the responsibilities now shared by nurses and other hospital employees.
If the pilot proves successful, he said, Piedmont will need to spend about $750,000 a year for an additional six pharmacists to take the program hospitalwide.
“We need to know that it works before we invest that kind of money because resources are more scarce than ever before,” Schreiber said. “National data suggests about 20 percent of all medication errors that occur in hospitals are related to having faulty medication reconciliation. If we can demonstrate there is a way to do medication reconciliation better, I would suggest an ethical mandate for all hospitals to do so from a patient safety standpoint.”
He added that “conservative numbers are in the millions for potential cost savings at hospitals if we can identify a process that results in more accurate information from the patient.”
Shelly Bird, the chairwoman of the Cardinal Health Foundation, said medication safety and health-care-associated infections are two of the largest patient safety issues that health organizations face daily, and the human toll and financial burden are escalating.
An article published by the National Academy of Sciences in 2000 estimated that 7,000 U.S. deaths per year are related to medication inaccuracies.
Factors identified as contributing to inaccuracies include low health literacy of patients, language barriers, current health status and memory impairment of patients, Schreiber said.