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J Am Pharm Assoc (2003). 2003 Sep-Oct;43(5):622-8; quiz 628-9.

Managing the aftermath of medication errors: managed care's role.

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Mylan School of Pharmacy, Duquesne University, 306 Bayer Learning Center, Pittsburgh, PA 15282, USA.



To discuss managed care's role in managing an organization's response to a medication error and to provide specific recommendations for that response.


Published articles and reports related to crisis management, service failure, public relations, ethics, psychology, management, marketing, health care, and law. Review of the literature on crisis management and service failure was extensive. ProQuest and MEDLINE databases were searched. Search terms were medication error, medical error, and organizational crisis.


Studies were selected on the basis of their relevance to practitioners.


Medication errors place practitioners, pharmacies, and health care organizations under severe emotional, physical, and financial stress. Managed poorly, a medication error can have disastrous consequences for all involved. When the response is managed correctly, a medication error presents a challenge, but one that is survivable and potentially instructive. Managed care should develop and disseminate best practices for responding to errors and lead the development and adoption of technologies and systems designed to curtail the number of errors and reduce the costs associated with those errors. Effectively responding to a medication error allows the pharmacy organization to maintain or resume its core activities while minimizing stakeholders' losses. The lessons learned in the process of managing the aftermath of a medication error should be incorporated into ongoing quality improvement programs.


Based on the literature review and the ideas presented, specific recommendations for responding to catastrophic medication errors are made. Following those recommendations would allow those in the health care system--managed care organizations and individual practitioners--to improve their image and do good at the same time.

[Indexed for MEDLINE]
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