Drug-use review and risk management.

The concept of a combined drug-use-review (DUR) and risk-management program is discussed. Traditionally, hospital quality-assurance efforts addressed issues of patient care while risk management dealt with hospital liability by ensuring patients' custodial safety. Because most malpractice claims result from negligence in patient care, an integrated approach to quality assurance and risk management is appropriate. One of the first steps in improving patient care and reducing hospital liability is prevention of avoidable, medically related patient injuries. Studies show that many medical injuries are related to drug exposure. Concurrent comparison of medication orders and administration with selected process criteria could provide early detection and prevention of many drug-related episodes.