Document Detail


Field test results of a new ambulatory care Medication Error and Adverse Drug Event Reporting System--MEADERS.
MedLine Citation:
PMID:  21060122     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: In this study, we developed and field tested the Medication Error and Adverse Drug Event Reporting System (MEADERS)-an easy-to-use, Web-based reporting system designed for busy office practices.
METHODS: We conducted a 10-week field test of MEADERS in which 220 physicians and office staff from 24 practices reported medication errors and adverse drug events they observed during usual clinical care. The main outcomes were (1) use and acceptability of MEADERS measured with a postreporting survey and interviews with office managers and lead physicians, and (2) distributions of characteristics of the medication event reports.
RESULTS: A total of 507 anonymous event reports were submitted. The mean reporting time was 4.3 minutes. Of these reports, 357 (70%) included medication errors only, 138 (27%) involved adverse drug events only, and 12 (2.4%) included both. Medication errors were roughly equally divided among ordering medications, implementing prescription orders, errors by patients receiving the medications, and documentation errors. The most frequent contributors to the medication errors and adverse drug events were communication problems (41%) and knowledge deficits (22%). Eight (1.6%) of the reported events led to hospitalization. Reporting raised staff and physician awareness of the kinds of errors that occur in office medication management; however, 36% agreed or strongly agreed that the event reporting "has increased the fear of repercussion in the practice." Time pressure was the main barrier to reporting.
CONCLUSIONS: It is feasible for primary care clinicians and office staff to report medication errors and adverse drug events to a Web-based reporting system. Time pressures and a punitive culture are barriers to event reporting that must be overcome. Further testing of MEADERS as a quality improvement tool is warranted.
Authors:
John Hickner; Atif Zafar; Grace M Kuo; Lyle J Fagnan; Samuel N Forjuoh; Lyndee M Knox; John T Lynch; Brian Kelly Stevens; Wilson D Pace; Benjamin N Hamlin; Hilary Scherer; Brenda L Hudson; Caitlin Carroll Oppenheimer; William M Tierney
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of family medicine     Volume:  8     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-11-09     Completed Date:  2011-02-24     Revised Date:  2011-07-28    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  517-25     Citation Subset:  IM    
Affiliation:
Department of Family Medicine and the Medicine Institute, Cleveland Clinic, Cleveland, OH 44195, USA. hicknej@ccf.org
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MeSH Terms
Descriptor/Qualifier:
Adverse Drug Reaction Reporting Systems / organization & administration,  statistics & numerical data*
Ambulatory Care / statistics & numerical data*
Feasibility Studies
Humans
Medication Errors / prevention & control,  statistics & numerical data*
Online Systems
Pilot Projects
Primary Health Care / statistics & numerical data*
Quality of Health Care / statistics & numerical data
Questionnaires
Risk Management
United States
Grant Support
ID/Acronym/Agency:
290880008//PHS HHS
Comments/Corrections

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