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Rice tackles improving medication safety

WILLMAR -- New "smart" drug pumps at Rice Memorial Hospital have been alerting nurses to errors -- a dose of Dilaudid, a painkiller, that was accidentally programmed for 2 milligrams per hour instead of 0.2 milligrams, for instance -- so that the error can be fixed before it reaches the patient.

Carnie Allex, director of pharmacy at the hospital, knows this because it's one of the things being tracked in Rice Hospital's efforts to improve patient safety.

"We know with the software data it was caught and the dose was reprogrammed," she said.

Over the past five years, Minnesota hospitals have made significant strides in preventing errors that put patients at risk or lead to injury.

It's a long, complicated road, however, that involves intense teamwork and a high degree of commitment, say hospital officials.

Take medication safety, a key area for hospitals and one that can be a major source of serious errors.

"You would think that getting the right medication to the right patient at the right time and the right dose would be a slam dunk. But it's a very complicated process. No hospital I know of does it perfectly," said Dr. Norris Anderson, medical director for care improvement at Rice Hospital.

At least three projects implemented at Rice Hospital last year are aimed at increasing medication safety.

One was the installation of "smart" pumps last June for delivering continuous intravenous drugs. Allex said software was added that helps increase safety by sounding an alert if a medication is programmed incorrectly.

"We're trying to get the use as high as possible," she said. "There are errors being made and the software is helping catch them. It's a safer feeling from our staff who take care of patients and use this day in and day out."

Another improvement: changing the process of stocking and managing the hospital's 11 automatic dispensing machines from which nurses obtain most of the medications they give to patients.

The procedure is now more streamlined and efficient, which allows the pharmacy staff to spend more time on other priorities, Allex said.

In mid-August, an electronic medication administration record was added. This puts the information in one place that's easily accessible to physicians and nurses, said Kathy Dillon, director of information management.

"Not having to find the chart was something people really commented on when we went live with this," she said.

With the elimination of hand-written orders, fewer medication errors are anticipated, she said.

Medication safety is an area to which Rice Hospital has devoted considerable attention, said Dale Hustedt, interim chief executive.

"The volume of medications that are prescribed and given to patients is so large," he said. "It just demands a lot of attention."

In 2009, hospital teams will be working on 23 different care improvement projects, ranging from best-practice care for patients with stroke, heart attack and heart failure, to improving the discharge process for patients and families.