Implementing a New Electronic Health Record System in a University Hospital : The Effect on Reported Medication Errors

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http://hdl.handle.net/10138/346131

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Linden-Lahti , C , Kivivuori , S-M , Lehtonen , L & Schepel , L 2022 , ' Implementing a New Electronic Health Record System in a University Hospital : The Effect on Reported Medication Errors ' , Healthcare , vol. 10 , no. 6 , 1020 . https://doi.org/10.3390/healthcare10061020

Title: Implementing a New Electronic Health Record System in a University Hospital : The Effect on Reported Medication Errors
Author: Linden-Lahti, Carita; Kivivuori, Sanna-Maria; Lehtonen, Lasse; Schepel, Lotta
Contributor organization: HUS Pharmacy
Division of Pharmacology and Pharmacotherapy
Faculty of Pharmacy
HUS Children and Adolescents
HUSLAB
Department of Public Health
Clinicum
Date: 2022-06
Language: eng
Number of pages: 12
Belongs to series: Healthcare
ISSN: 2227-9032
DOI: https://doi.org/10.3390/healthcare10061020
URI: http://hdl.handle.net/10138/346131
Abstract: Closed-loop electronic medication management systems (EMMS) have been seen as a potential technology to prevent medication errors (MEs), although the research on them is still limited. The aim of this paper was to describe the changes in reported MEs in Helsinki University Hospital (HUS) during and after implementing an EPIC-based electronic health record system (APOTTI), with the first features of a closed-loop EMMS. MEs reported from January 2018 to May 2021 were analysed to identify changes in ME trends with quantitative analysis. Severe MEs were also analysed via qualitative content analysis. A total of 30% (n = 23,492/79,272) of all reported patient safety incidents were MEs. Implementation phases momentarily increased the ME reporting, which soon decreased back to the earlier level. Administration and dispensing errors decreased, but medication reconciliation, ordering, and prescribing errors increased. The ranking of the TOP 10 medications related to MEs remained relatively stable. There were 92 severe MEs related to APOTTI (43% of all severe MEs). The majority of these (55%, n = 53) were related to use and user skills, 24% (n = 23) were technical failures and flaws, and 21% (n = 21) were related to both. Using EMMS required major changes in the medication process and new technical systems and technology. Our medication-use process is approaching a closed-loop system, which seems to provide safer dispensing and administration of medications. However, medication reconciliation, ordering, and prescribing still need to be improved.
Subject: electronic health record system
electronic medication management system
EPIC
APOTTI
medication error reporting
prescribing errors
medication safety
patient safety
ADMINISTRATION ERRORS
MANAGEMENT-SYSTEMS
SAFETY
PHARMACIST
USABILITY
IMPACT
CARE
317 Pharmacy
3141 Health care science
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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