Medicare to Penalize Hospitals for Preventable Medication Errors
Medicare has announced that, beginning in 2013, the organization will begin to penalize hospitals that exhibit high rates of preventable readmissions. As a result, hospitals are cracking down on prescription drug errors in recently discharged patients—the number one factor contributing to re-hospitalization.
According to data published in a 2011 issue of the New England Journal of Medicine, one out of every five discharged Medicare patients will be readmitted within 30 days, mostly as a result of prescription drug mistakes. In order to keep Medicare revenue, hospitals have started instituting discharge programs that give patients some one-on-one time with a pharmacist in order to understand their at-home medication regime.
“We know that the main drivers for readmissions are drug-related, especially among the elderly,” says Patricia C. Kienle, RPh, MPA, FASHP, Director of Accreditation and Medication Safety Quality Services at Cardinal Health Pharmacy Solutions. “That means pharmacists at health systems and in the community are well positioned to address some of the problems.”
Researchers believe there are a number of reasons elderly patients experience medication errors, including:
Lack of communication among clinicians, patients and caregivers
Incomplete or infrequent recordkeeping
Lack of patient medication training at the time of discharge
Lack of patient medication reviews
Lack of patient/physician follow-up appointments
Failure of patients to identify potential dangerous side effects
While studies have shown that pharmacist counseling at discharge can result in a nearly 90% reduction of preventable medication mistakes, researchers emphasize that a complete medication record at the time patients are admitted to the hospital is crucial as well.
“The key piece of the medication reconciliation is having a good admission record as the patient enters the system,” says Marialice S. Bennett, RPh, FAPhA, Professor of Clinical Pharmacy at the Ohio State University College of Pharmacy in Columbus. Bennett remarked at a 2011 meeting of American Society of Health-System Pharmacists that a complete pharmaceutical record means more than merely asking a patient which medications he is taking, since patients usually provide incomplete or unreliable health records.
“The pharmacist or pharmacy technician assembling the medication list must dig deeper, perhaps calling pharmacies, physician offices and family members,” Bennett said.
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