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Hosp Pharm. 2013 Jan;48(1):39-47. doi: 10.1310/hpj4801-39.test.

Implementation of a Standardized Discharge Time-out Process to Reduce Prescribing Errors at Discharge.

Author information

1
Assistant Director.
2
Clinical Manager.
3
Fellow, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
4
Clinical Director, Department of Pharmacy, Wake Forest Baptist Health, Winston-Salem, North Carolina.

Abstract

BACKGROUND:

To reduce prescribing errors occurring on discharge from the hospital, a standardized discharge time-out process was implemented on a general medicine service at Wake Forest Baptist Medical Center. In the time-out process, the multidisciplinary care team reviewed the patient's medical records together to determine the optimal discharge medication regimen. This regimen was recorded on a time-out form and then was used to develop the patient's discharge documents.

OBJECTIVE:

To evaluate the impact of a standardized discharge time-out process on prescribing errors that occur as patients are discharged from a general medicine service.

METHODS:

The medical records of all patients discharged from a general medicine service during 60-day periods before ("pre-group") and after ("post-group") implementation of a standardized discharge time-out process were retrospectively reviewed by an internal medicine physician to determine the presence of discharge prescribing errors.

RESULTS:

There were 142 and 124 evaluable patients in the pre- and post-groups, respectively. Compliance with the time-out process was 93% in the post-group. At least 1 prescribing error was detected in 49 (34.5%) of the discharges in the pre-group and 17 (13%) of the discharges in the post-group (P < .0001). All of the errors noted in the post-group occurred in discharges in which a clinical pharmacist was not involved.

CONCLUSIONS:

A multidisciplinary, standardized discharge time-out process was associated with a dramatic reduction in prescribing errors when patients were discharged from a general medicine service. The time-out process is one strategy to improve patient safety at hospital discharge.

KEYWORDS:

discharge; medication safety; prescribing errors; time-out

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