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BWH leaders celebrate eMAR successes with just a portion of those involved.
BWH administers a dose of medication every five seconds. That's 6.2 million doses per year, a tremendous responsibility when caring for and healing patients, but also a large window for potential medication errors.
That's why BWH's landmark electronic medication administration system is so important to patient safety. eMAR-which electronically links physicians writing prescriptions, pharmacists reviewing orders and nurses administering them-has reduced significantly the number of medication errors. Targeted pharmacy dispensing errors have been reduced by 85 percent, and potential adverse events by about 63 percent. Jennifer Cina, PharmD, Tejal Gandhi, MD, MPH, and several of their BWH colleagues detailed these findings in the February 2006 Joint Commission Journal on Quality and Patient Safety.
Last month, nearly 50 BWHers gathered to celebrate the system's successes at a reception in the PBB Rotunda. "I can't tell you how proud we are of all of you," Andy Whittemore, MD, chief medical officer, said to those involved in eMAR implementation and testing, including Pharmacy, Nursing, IS, Patient Care Services, physicians and housestaff.
BWH began developing its seamless electronic medication administration system in 2001. Without available commercial products to suit its needs, the hospital forged its own path and designed a new system, including a pharmacy system to drive the entire process and a drug repackaging center, which became "the envy of hospitals around the country," said Bill Churchill, MS, RPh, director of Pharmacy.
"What separates us from other hospitals is the ability to be innovative and creative and design for the future-not where we want to be now, but five to ten years from now and beyond," Churchill said.
In designing the bar-coding system, BWH examined best practices both within and outside the health care industry. For example, the adoption of a two-dimensional bar code similar to what Fed Ex uses allows the pharmacy to store more information, including the drug expiration date. These bar codes proved critical to avoiding medication errors, and today, many drug manufacturers are seeking BWH's input in bar coding their drugs.
The combination of bar code technology and the electronic medication administration record is promising for reducing administration errors by nurses, who were critical in both developing the system with a multidisciplinary team of Pharmacy, IS, Nursing and physicians, and providing feedback in the pilot stages.
During last month's celebration, Mairead Hickey, PhD, RN, chief nursing officer and senior vice president of Patient Care Services, said that eMAR has made believers out of many nurses. The safeguards, which require nurses to scan bar codes on both a patient's wristband and the medication before administering it, have caught many potential errors. "So many nurses have told me about first-time incidents when eMAR caught an error and made them instant believers," Hickey said.