Medication reconciliation to improve quality of transitional care.

药物协调以提高过渡护理的质量。

• 批准号: 7938104
• 负责人: MICHAEL WEINER
• 金额: $ 42.16万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7938104
• 关键词: Medication; reconciliation; improve; quality; transitional; Medication; reconciliation; improve; quality; transitional

DESCRIPTION (provided by applicant): Medical errors are common and dangerous. Approximately 20% of medical errors are related to prescription of medications. Most medication errors occur at transitions in care, such as when patients are admitted from ambulatory settings to hospitals or discharged from hospitals to ambulatory settings. Since prescriptions at hospital discharge are intended to be followed in ambulatory care, improving transitional and ambulatory care requires attention to the discharge prescriptions. With medication reconciliation (MR), multiple sources of medication information are reviewed, to determine which medications are currently active, and which medications should be prescribed. The process of MR is tedious and time-consuming. Although implementation of formal MR systems improves the fraction of cases undergoing MR, we know relatively little about the extent to which MR systems alter clinical outcomes. Research also indicates that MR should be integrated with computer-based provider order entry (CPOE), but this seldom if ever occurs. The specific aims of this study are to integrate an electronic MR system with an electronic prescribing system, conduct a randomized controlled trial of MR, and determine whether electronic facilitation of MR alters MR and the incidence of medication errors in ambulatory care. On a patient's hospital admission, a Web-based MR module will receive an automatically compiled outpatient medication list. Following discussion with the patient, medical personnel will update the list, which will then be delivered to the CPOE system and become actionable for prescribing. Main outcomes include adverse drug events and erroneous discrepancies between the pre-admission medication list and the medication list upon the patient's return to ambulatory care. We hypothesize that electronic facilitation of inpatient MR will improve completion of MR and will decrease the incidence of drug-related medical errors.

描述（由申请人提供）：医疗错误是常见和危险的。大约20％的医疗错误与药物处方有关。大多数药物错误发生在护理过渡时，例如，当患者从卧床环境接纳到医院或从医院出院到门诊环境时。由于出院时的处方旨在在门诊护理中遵循，因此改善过渡和门诊护理需要注意出院处方。借助药物对帐（MR），审查了多种药物信息来源，以确定当前有活性的药物，以及应处方哪些药物。 MR的过程乏味且耗时。尽管实施正式MR系统可以改善接受MR的病例的比例，但我们对MR系统改变临床结果的程度相对较少。研究还表明，MR应与基于计算机的提供商订单输入（CPOE）集成，但是如果有的话，这很少发生。这项研究的具体目的是将电子MR系统与电子处方系统相结合，进行MR的随机对照试验，并确定电子促进MR的MR和AMBITARE CARE中药物错误的发生率是否发生。在患者的医院入院中，基于网络的MR模块将获得自动汇编的门诊药物清单。在与患者进行讨论之后，医务人员将更新列表，然后将其交付到CPOE系统，并可用于开处方。主要结果包括不良药物事件和入学前药物清单与药物清单之间的错误差异。我们假设电子促进住院MR将改善MR的完成，并将减少与药物相关的医疗错误的发生。