Salemi Charles S, Singleton Norvella
Perm J. 2007 Spring;11(2):31-4. doi: 10.7812/TPP/06-076.
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) instituted a new regulation in 2006 to improve patient safety by decreasing medication errors. This requires a process for obtaining and documenting a complete list of each patient's current medications at hospital admission and communicating this list to the next clinician ("Medication Reconciliation").
We sought to determine whether medication discrepancies between outpatient and inpatient care can be decreased through the use of computerized pharmacy data.
We evaluated outpatient medication prescriptions in 2000 and 2004 using computer-generated data for patients admitted from an Emergency Department to a medical ward. The hospital records and pharmacy data were reviewed to determine which ambulatory medications were ordered at admission, continued as an out-patient, and refilled three months after discharge. In 2004 additional computerized pharmacy data were provided to attending physicians. Ambulatory care "essential prescription medication groups" (cardiac, chronic obstructive pulmonary disease, asthma, diabetes, and neurologic) were also evaluated. Medication discrepancies for the years 2000 and 2004 were compared in several categories.
Medication discrepancies were found in all evaluated categories in 2000. The follow-up study showed a decrease in discrepancies for nearly all categories.
RESULTS show that use of outpatient pharmacy data can decrease medication discrepancies in compliance with current JCAHO requirements.
医疗组织认证联合委员会（JCAHO）于2006年制定了一项新规定，旨在通过减少用药错误来提高患者安全。这要求建立一个流程，在患者入院时获取并记录其当前所有药物的完整清单，并将该清单传达给下一位临床医生（“用药核对”）。
我们试图确定通过使用计算机化药房数据是否可以减少门诊和住院治疗之间的用药差异。
我们利用计算机生成的数据，对2000年和2004年从急诊科收治到内科病房的患者的门诊用药处方进行了评估。审查医院记录和药房数据，以确定哪些门诊药物在入院时被开出、作为门诊药物继续使用以及出院三个月后重新配药。2004年，向主治医生提供了额外的计算机化药房数据。还对门诊护理“基本处方药物组”（心脏、慢性阻塞性肺疾病、哮喘、糖尿病和神经科）进行了评估。对2000年和2004年的用药差异在几个类别中进行了比较。
2000年在所有评估类别中均发现用药差异。后续研究表明，几乎所有类别的差异都有所减少。
结果表明，使用门诊药房数据可以按照当前JCAHO的要求减少用药差异。
