Excerpt

This volume comprises papers devoted to the development and use of technology—principally health information technology (health IT)—and strategies to enhance medication safety, both of which are critical to improving the delivery of safe, effective health care.

We are already using health IT in a number of ways: to help prevent medical errors, including adverse drug events; reduce costs through streamlining processes and providing more targeted, efficient care; help patients manage their chronic illnesses; enhance the delivery of targeted, patient-centered care; measure provider and facility performance; and facilitate rapid access and dissemination of accurate medical information in the event of a public health emergency.

Health IT can provide access to real-time information to support clinical decisionmaking, promote evidence-based care, organize and streamline the referral process, facilitate the order entry process, and consolidate patient information into one easily accessible, accurate, and up to date source. The use and usefulness of health IT are evolving, and we certainly will see many new applications of health IT in the coming months and years. New forms of information packaging and presentation will be critical in helping health IT grow and develop as health care itself changes over time.

Contents

• Preface
• Acknowledgments
• Prologue: Technology and Medication Safety
• Health Information Technology
  • “Safeware”: Safety-Critical Computing and Health Care Information Technology
    Robert L. Wears and Nancy G. Leveson.
    • Introduction
    • Safeware Principles: A Brief Outline of the Safeware Approach
    • A Guide to Further Learning
    • Conclusion
    • References
  • Improving Perioperative Patient Safety Through the Use of Information Technology
    Paul J. St. Jacques and Michael N. Minear.
    • Perioperative Care: A Unique Environment
    • Conclusion
    • Appendix. Abbreviations and key terms
    • References
  • The Impact of Health Information Technology on Work Process and Patient Care in Labor and Delivery
    Emily M. Campbell, Hong Li, Tomi Mori, Patricia Osterweil, and Jeanne-Marie Guise.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgment
    • References
  • Consolidated Imaging: Implementing a Regional Health Information Exchange System for Radiology in Southern Maine
    Stephenie Loux, Robert Coleman, Matthew Ralston, and Andrew Coburn.
    • Introduction
    • Creating a Shared PACS in Maine
    • Conclusion
    • Acknowledgments
    • References
  • Personal Health Records to Improve Health Information Exchange and Patient Safety
    James R. Fricton and Diane Davies.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgments
    • References
  • Improving Patient Safety Using ATHENA-Decision Support System Technology: The Opioid Therapy for Chronic Pain Experience
    Martha Michel, Jodie Trafton, Susana Martins, Dan Wang, Samson Tu, Naquell Johnson, and Mary K. Goldstein.
    • Introduction
    • Elements of Athena-Opioid Therapy Designed to Increase Patient Safety
    • Discussion
    • Conclusion
    • Acknowledgments
    • References
  • Implementing an Ambulatory e-Prescribing System: Strategies Employed and Lessons Learned to Minimize Unintended Consequences
    Emily B. Devine, Jennifer L. Wilson-Norton, Nathan M. Lawless, Ryan N. Hansen, William Hollingworth, Albert W. Fisk, and Sean D. Sullivan.
    • Introduction
    • Developing and Implementing the Homegrown e-Prescribing System
    • Discussion
    • Conclusion
    • Acknowledgment
    • References
  • Measuring IT Sophistication in Nursing Homes
    Gregory L. Alexander, Dick Madsen, Stephanie Herrick, and Brady Russell.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgments
    • References
  • The Potential of Hand-held Assistive Technology to Improve Safety for Elder Adults Aging in Place
    Shirley Ann Becker and Frank M. Webbe.
    • Introduction
    • PocketPC Technology
    • Methods
    • Results
    • Conclusion
    • Acknowledgments
    • References
  • Efficiency Gains with Computerized Provider Order Entry
    Andrew M. Steele and Mical DeBrow.
    • Introduction
    • Results
    • Discussion
    • Methods
    • Conclusion
    • References
• Medication Safety
  • Clinical Pharmacists in Emergency Medicine
    Rollin J. Fairbanks, Erik A. Rueckmann, Karen E. Kolstee, Daniel P. Hays, Daniel J. Cobaugh, Robert L. Wears, Karen H. Dewar, Heather A. Martin, Colleen O. Davis, Sandra M. Schneider, and Manish N. Shah.
    • Introduction
    • Evidence to Support the Value of a Clinical Pharmacist
    • Optimization of the Emergency Pharmacists’ Role in Medication Safety
    • Staff Perceptions of the Emergency Pharmacist Program
    • Conclusion
    • Acknowledgments
    • Appendix 1. Sample Education and Training Requirements for an Emergency Pharmacist position
    • Appendix 2. Sample Emergency Pharmacist Job Description
    • References
  • Intravenous Infusion Safety Initiative: Collaboration, Evidence-Based Best Practices, and “Smart” Technology Help Avert High-Risk Adverse Drug Events and Improve Patient Outcomes
    Ray R. Maddox, Sherry Danello, Carolyn K. Williams, and Marianne Fields.
    • Introduction
    • The IV Infusion Safety Initiative at St. Joseph’s/Candler Health System
    • Results
    • Nursing Satisfaction
    • Discussion
    • Conclusion
    • References
  • Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period
    Ray R. Maddox, Harold Oglesby, Carolyn K. Williams, Marianne Fields, and Sherry Danello.
    • Introduction
    • Implementation Methodology
    • Results
    • Discussion
    • Conclusion
    • References
  • Evaluation of a Medication Therapy Management Program in Medicare Beneficiaries at High Risk of Adverse Drug Events: Study Methods
    Andrew L. Masica, Daniel R. Touchette, Rowena J. Dolor, Glen T. Schumock, Mary Ann Kliethermes, Philip T. Rodgers, Jennifer L. Craft, Young-Ku Choi, Linda J. Lux, and Scott R. Smith.
    • Introduction
    • Methods
    • Discussion
    • Conclusion
    • Acknowledgments
    • References
  • Medication Management Transactions and Errors in Family Medicine Offices: A Pilot Study
    John Lynch, Jonathan Rosen, H. Andrew Selinger, and John Hickner.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgments
    • References
  • Evaluation of Medications Removed from Automated Dispensing Machines Using the Override Function Leading to Multiple System Changes
    Karla Miller, Manisha Shah, Laura Hitchcock, Alicia Perry, Jane Englebright, Jonathan Perlin, and Hayley Burgess.
    • Introduction
    • Methods
    • Results
    • Discussion
    • References
  • Imbedding Research in Practice to Improve Medication Safety
    Marsha A. Raebel, Elizabeth A. Chester, David W. Brand, and David J. Magid.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusion
    • Acknowledgments
    • Appendix A. Renal Dosing Guidelines
    • Appendix B. Drug-Elderly Intervention Guidelines
    • References
  • Risk of Concurrent Use of Prescription Drugs with Herbal and Dietary Supplements in Ambulatory Care
    Robert E. Graham, Tejal K. Gandhi, Joshua Borus, Andrew C. Seger, Elisabeth Burdick, David W. Bates, Russell S. Phillips, and Saul N. Weingart.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Acknowledgments
    • References
  • Using Home Visits to Understand Medication Errors in Children
    Kathleen E. Walsh, Christopher J. Stille, Kathleen M. Mazor, and Jerry H. Gurwitz.
    • Introduction
    • Literature Review
    • Methods
    • Conclusion
    • Acknowledgments
    • Appendix A. Home Visit Data Collection Form
    • Appendix B. Error Report Form
    • References
  • Developing a Community-Wide Electronic Shared Medication List
    Ron Stock, Eldon R. Mahoney, Dawn Gauthier, Linda Center, Mary Minniti, James Scott, Marc Pierson, and Lori Nichols.
    • Introduction
    • Methods
    • Results
    • Discussion
    • Conclusion
    • References
• Peer Reviewers—Volume 4

Suggested citation:

Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in patient safety: New directions and alternative approaches. Vol. 4. Technology and Medication Safety. AHRQ Publication No. 08-0034-4. Rockville, MD: Agency for Healthcare Research and Quality; August 2008.