Ring Lisa M, Cinotti Jamie, Hom Lisa A, Mullenholz Mary, Mangum Jordan, Ahmed-Winston Sameeya, Cheng Jenhao Jacob, Randolph Ellie, Harahsheh Ashraf S
Children's National Heart Institute, Children's National Hospital, Washington, D.C.
Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, D.C.
Pediatr Qual Saf. 2023 Jul 10;8(4):e671. doi: 10.1097/pq9.0000000000000671. eCollection 2023 Jul-Aug.
Medication errors are a leading safety concern, especially for families with limited English proficiency and health literacy, and patients discharged on multiple medications with complex schedules. Integration of a multilanguage electronic discharge medication platform may help decrease medication errors. This quality improvement (QI) project's primary aim (process measure) was to increase utilization in the electronic health record (EHR) of the integrated MedActionPlanPro (MAP) for cardiovascular surgery and blood and marrow transplant patients at hospital discharge and for the first clinic follow-up visit to 80% by July 2021.
This QI project occurred between August 2020 and July 2021 on 2 subspecialty pediatric acute care inpatient units and respective outpatient clinics. An interdisciplinary team developed and implemented interventions, including integration of MAP within EHR; the team tracked and analyzed outcomes for discharge medication matching, and efficacy and safety MAP integration occurred with a go-live date of February 1, 2021. Statistical process control charts tracked progress.
Following the implementation of the QI interventions, there was an increase from 0% to 73% in the utilization of the integrated MAP in the EHR across the acute care cardiology unit-cardiovascular surgery/blood and marrow transplant units. The average user hours per patient () decreased 70% from the centerline of 0.89 hours during the baseline period to 0.27 hours. In addition, the medication matching between Cerner inpatient and MAP inpatient increased significantly from baseline to postintervention by 25.6% ( < 0.001).
MAP integration into the EHR was associated with improved inpatient discharge medication reconciliation safety and provider efficiency.
用药错误是一个主要的安全问题，对于英语水平有限和健康素养较低的家庭，以及出院时服用多种用药计划复杂的药物的患者来说尤其如此。整合多语言电子出院用药平台可能有助于减少用药错误。这个质量改进（QI）项目的主要目标（过程指标）是到2021年7月，将心血管手术以及血液和骨髓移植患者在出院时和首次门诊随访时综合使用的MedActionPlanPro（MAP）在电子健康记录（EHR）中的利用率提高到80%。
这个QI项目于2020年8月至2021年7月在2个儿科亚专科急性护理住院单元及其各自的门诊诊所开展。一个跨学科团队制定并实施了干预措施，包括将MAP整合到EHR中；该团队跟踪并分析出院用药匹配的结果，以及MAP整合的有效性和安全性。整合于2021年2月1日上线。统计过程控制图跟踪进展情况。
实施QI干预措施后，急性护理心脏病单元 - 心血管手术/血液和骨髓移植单元中，EHR中综合MAP的利用率从0%提高到了73%。每位患者的平均用户用时（）从基线期的0.89小时中心线下降了70%，降至0.27小时。此外，Cerner住院患者和MAP住院患者之间的用药匹配从基线到干预后显著增加了25.6%（<0.001）。
将MAP整合到EHR中与改善住院患者出院用药核对的安全性和提高医护人员效率相关。
