Improving a Medication Error Monitoring Program at an Acute-Care Hospital

Abstract

This report describes the development and implementation of a medication error monitoring program (MEMP) at an acute-care hospital in a multisite health care system. Data from every reported potential error (mistakes in prescribing, transcribing, dispensing, or planned administration that are detected and corrected before actual administration) and actual error (mistakes identified after drug is administered or failure to administer a scheduled drug) were entered in an electronic database. Medication errors with more than one potential cause were counted more than once. A designated pharmacist, in consultation with other health care professionals, assigned a severity level (levels I–IV; from no apparent injury to permanent functional impairment or death based on published definitions¹) to the clinical outcome of every error. A summary of the data and performance improvement activities were reported to the hospital's Pharmacy and Therapeutics Committees, Quality Improvement Committees, and Board of Trustees.