James R Beardsley1, Regina H Schomberg2, Steven J Heatherly3, Beth S Williams4. 1. Assistant Director. 2. Clinical Manager. 3. Fellow, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina. 4. Clinical Director, Department of Pharmacy, Wake Forest Baptist Health, Winston-Salem, North Carolina.
Abstract
BACKGROUND: To reduce prescribing errors occurring on discharge from the hospital, a standardized discharge time-out process was implemented on a general medicine service at Wake Forest Baptist Medical Center. In the time-out process, the multidisciplinary care team reviewed the patient's medical records together to determine the optimal discharge medication regimen. This regimen was recorded on a time-out form and then was used to develop the patient's discharge documents. OBJECTIVE: To evaluate the impact of a standardized discharge time-out process on prescribing errors that occur as patients are discharged from a general medicine service. METHODS: The medical records of all patients discharged from a general medicine service during 60-day periods before ("pre-group") and after ("post-group") implementation of a standardized discharge time-out process were retrospectively reviewed by an internal medicine physician to determine the presence of discharge prescribing errors. RESULTS: There were 142 and 124 evaluable patients in the pre- and post-groups, respectively. Compliance with the time-out process was 93% in the post-group. At least 1 prescribing error was detected in 49 (34.5%) of the discharges in the pre-group and 17 (13%) of the discharges in the post-group (P < .0001). All of the errors noted in the post-group occurred in discharges in which a clinical pharmacist was not involved. CONCLUSIONS: A multidisciplinary, standardized discharge time-out process was associated with a dramatic reduction in prescribing errors when patients were discharged from a general medicine service. The time-out process is one strategy to improve patient safety at hospital discharge.
BACKGROUND: To reduce prescribing errors occurring on discharge from the hospital, a standardized discharge time-out process was implemented on a general medicine service at Wake Forest Baptist Medical Center. In the time-out process, the multidisciplinary care team reviewed the patient's medical records together to determine the optimal discharge medication regimen. This regimen was recorded on a time-out form and then was used to develop the patient's discharge documents. OBJECTIVE: To evaluate the impact of a standardized discharge time-out process on prescribing errors that occur as patients are discharged from a general medicine service. METHODS: The medical records of all patients discharged from a general medicine service during 60-day periods before ("pre-group") and after ("post-group") implementation of a standardized discharge time-out process were retrospectively reviewed by an internal medicine physician to determine the presence of discharge prescribing errors. RESULTS: There were 142 and 124 evaluable patients in the pre- and post-groups, respectively. Compliance with the time-out process was 93% in the post-group. At least 1 prescribing error was detected in 49 (34.5%) of the discharges in the pre-group and 17 (13%) of the discharges in the post-group (P < .0001). All of the errors noted in the post-group occurred in discharges in which a clinical pharmacist was not involved. CONCLUSIONS: A multidisciplinary, standardized discharge time-out process was associated with a dramatic reduction in prescribing errors when patients were discharged from a general medicine service. The time-out process is one strategy to improve patient safety at hospital discharge.
Authors: Alex B Haynes; Thomas G Weiser; William R Berry; Stuart R Lipsitz; Abdel-Hadi S Breizat; E Patchen Dellinger; Teodoro Herbosa; Sudhir Joseph; Pascience L Kibatala; Marie Carmela M Lapitan; Alan F Merry; Krishna Moorthy; Richard K Reznick; Bryce Taylor; Atul A Gawande Journal: N Engl J Med Date: 2009-01-14 Impact factor: 91.245
Authors: Eefje N de Vries; Hubert A Prins; Rogier M P H Crolla; Adriaan J den Outer; George van Andel; Sven H van Helden; Wolfgang S Schlack; M Agnès van Putten; Dirk J Gouma; Marcel G W Dijkgraaf; Susanne M Smorenburg; Marja A Boermeester Journal: N Engl J Med Date: 2010-11-11 Impact factor: 91.245
Authors: Jacqueline D Wong; Jana M Bajcar; Gary G Wong; Shabbir M H Alibhai; Jin-Hyeun Huh; Annemarie Cesta; Gregory R Pond; Olavo A Fernandes Journal: Ann Pharmacother Date: 2008-10 Impact factor: 3.154
Authors: Jay G Berry; Kevin Blaine; Jayne Rogers; Sarah McBride; Edward Schor; Jackie Birmingham; Mark A Schuster; Chris Feudtner Journal: JAMA Pediatr Date: 2014-10 Impact factor: 16.193
Authors: Camilla B Pimentel; A Lynn Snow; Sarah L Carnes; Nishant R Shah; Julia R Loup; Tatiana M Vallejo-Luces; Caroline Madrigal; Christine W Hartmann Journal: J Gen Intern Med Date: 2021-02-08 Impact factor: 6.473