Jeffrey M Rothschild

Massachusetts General Hospital, Boston, Massachusetts, United States

Are you Jeffrey M Rothschild?

Claim your profile

Publications (74)485.65 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The failure of providers to communicate and follow up clinically significant test results (CSTR) is an important threat to patient safety. The Massachusetts Coalition for the Prevention of Medical Errors has endorsed the creation of systems to ensure that results can be received and acknowledged. In 2008 a task force was convened that represented clinicians, laboratories, radiology, patient safety, risk management, and information systems in a large health care network with the goals of providing recommendations and a road map for improvement in the management of CSTR and of implementing this improvement plan during the sub-force sequent five years. In drafting its charter, the task broadened the scope from "critical" results to "clinically significant" ones; clinically significant was defined as any result that requires further clinical action to avoid morbidity or mortality, regardless of the urgency of that action. The task force recommended four key areas for improvement--(1) standardization of policies and definitions, (2) robust identification of the patient's care team, (3) enhanced results management/tracking systems, and (4) centralized quality reporting and metrics. The task force faced many challenges in implementing these recommendations, including disagreements on definitions of CSTR and on who should have responsibility for CSTR, changes to established work flows, limitations of resources and of existing information systems, and definition of metrics. This large-scale effort to improve the communication and follow-up of CSTR in a health care network continues with ongoing work to address implementation challenges, refine policies, prepare for a new clinical information system platform, and identify new ways to measure the extent of this important safety problem.
    Joint Commission journal on quality and patient safety / Joint Commission Resources 11/2013; 39(11):517-27.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Electronic prescribing systems have often been promoted as a tool for reducing medication errors and adverse drug events. Recent evidence has revealed that adoption of electronic prescribing systems can lead to unintended consequences such as the introduction of new errors. The purpose of this study is to identify and characterize the unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in an outpatient pharmacy. A multidisciplinary team conducted direct observations of workflow in an independent pharmacy and semi-structured interviews with pharmacy staff members about their perceptions of the unrealized potential and residual consequences of electronic prescribing systems. We used qualitative methods to iteratively analyze text data using a grounded theory approach, and derive a list of major themes and subthemes related to the unrealized potential and residual consequences of electronic prescribing. We identified the following five themes: Communication, workflow disruption, cost, technology, and opportunity for new errors. These contained 26 unique subthemes representing different facets of our observations and the pharmacy staff's perceptions of the unrealized potential and residual consequences of electronic prescribing. We offer targeted solutions to improve electronic prescribing systems by addressing the unrealized potential and residual consequences that we identified. These recommendations may be applied not only to improve staff perceptions of electronic prescribing systems but also to improve the design and/or selection of these systems in order to optimize communication and workflow within pharmacies while minimizing both cost and the potential for the introduction of new errors.
    Journal of the American Medical Informatics Association 10/2013; · 3.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Antineoplastic preparation presents unique safety concerns and consumes significant pharmacy staff time and costs. Robotic antineoplastic and adjuvant medication compounding may provide incremental safety and efficiency advantages compared with standard pharmacy practices. We conducted a direct observation trial in an academic medical center pharmacy to compare the effects of usual/manual antineoplastic and adjuvant drug preparation (baseline period) with robotic preparation (intervention period). The primary outcomes were serious medication errors and staff safety events with the potential for harm of patients and staff, respectively. Secondary outcomes included medication accuracy determined by gravimetric techniques, medication preparation time, and the costs of both ancillary materials used during drug preparation and personnel time. Among 1,421 and 972 observed medication preparations, we found nine (0.7%) and seven (0.7%) serious medication errors (P = .8) and 73 (5.1%) and 28 (2.9%) staff safety events (P = .007) in the baseline and intervention periods, respectively. Drugs failed accuracy measurements in 12.5% (23 of 184) and 0.9% (one of 110) of preparations in the baseline and intervention periods, respectively (P < .001). Mean drug preparation time increased by 47% when using the robot (P = .009). Labor costs were similar in both study periods, although the ancillary material costs decreased by 56% in the intervention period (P < .001). Although robotically prepared antineoplastic and adjuvant medications did not reduce serious medication errors, both staff safety and accuracy of medication preparation were improved significantly. Future studies are necessary to address the overall cost effectiveness of these robotic implementations.
    Journal of Oncology Practice 11/2012; 8(6):344-349.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Harmful medication errors, or preventable adverse drug events (ADEs), are a prominent quality and cost issue in healthcare. Injectable medications are important therapeutic agents, but they are associated with a greater potential for serious harm than oral medications. The national burden of preventable ADEs associated with inpatient injectable medications and the associated medical professional liability (MPL) costs have not been previously described in the literature.
    American Health and Drug Benefits 11/2012; 5(7):1-10.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Continuous vital sign monitoring has the potential to detect early clinical deterioration. While commonly employed in the intensive care unit (ICU), accurate and noninvasive monitoring technology suitable for floor patients has yet to be used reliably. To establish the accuracy of the Earlysense continuous monitoring system in predicting clinical deterioration. Noninterventional prospective study with retrospective data analysis. Two medical wards in 2 academic medical centers. Patients admitted to a medical ward with a diagnosis of an acute respiratory condition. Enrolled patients were monitored for heart rate (HR) and respiration rate (RR) by the Earlysense monitor with the alerts turned off. Retrospective analysis of vital sign data was performed on a derivation cohort to identify optimal cutoffs for threshold and 24-hour trend alerts. This was internally validated through correlation with clinical events recognized through chart review. Of 113 patients included in the study, 9 suffered major clinical deterioration. Alerts were found to be infrequent (2.7 and 0.2 alerts per patient-day for threshold and trend alert, respectively). For the threshold alerts, sensitivity and specificity in predicting deterioration was found to be 82% and 67%, respectively, for HR and 64% and 81%, respectively, for RR. For trend alerts, sensitivity and specificity were 78% and 90% for HR, and 100% and 64% for RR, respectively. The Earlysense monitor was able to continuously measure RR and HR, providing low alert frequency. The current study provides data supporting the ability of this system to accurately predict patient deterioration. Journal of Hospital Medicine 2012; © 2012 Society of Hospital Medicine.
    Journal of Hospital Medicine 08/2012; 7(8):628-33. · 1.40 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An evaluation of risk factors for adverse drug events in critically ill patients has not been previously studied. The purpose of this original study was to determine risk factors for adverse drug events in critically ill adult patients. This retrospective case-control study includes patients who were admitted to the intensive care unit during a 7.5-yr period. Academic medical center with 647 beds that contains approximately 120 intensive care unit beds. Patients in the case group experienced an adverse drug event as documented in the hospital's database. The control group comprised the next two patients admitted to the same intensive care unit by the same admitting service. None. Twenty-nine suspected risk factors identified from the literature were evaluated, including patient characteristics, drug characteristics, and laboratory values using a multiple logistic regression. A sample of 1101 cases and controls (54% male), with a mean age of 59.4 ± 17.5 yrs, were identified. In 367 cases, there was a total of 499 documented adverse drug events. Patients with kidney injury, thrombocytopenia, and those admitted emergently were 16-times, 3-times, and 2-times more likely to have an adverse drug event, respectively. Patients who were administered intravenous medications had a 3% higher risk of having an adverse drug event for each drug dispensed. Overall, the case group received more drugs per intensive care unit day and more drugs per intensive care unit stay. Several patient and drug-related characteristics contribute to the risk of adverse drug events in critically ill patients. Diligent monitoring of factors that can influence the pharmacokinetic properties for existing drug therapies is necessary. Drug regimens should be evaluated daily for minimization. Based on previous studies, pharmacists as part of the interdisciplinary team could help to manage these risks.
    Critical care medicine 03/2012; 40(3):823-8. · 6.37 Impact Factor
  • Jeffrey L Schnipper, Jeffrey M Rothschild
    The Lancet 02/2012; 379(9823):1278-80. · 39.06 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The results of an evaluation of the impact of pharmacists' medication-related interventions on quality of care in the emergency department (ED) setting are reported. Using data from a previously published observational study of medication errors intercepted by ED pharmacists at four academic medical centers, trained reviewers retrospectively analyzed 130 additional pharmacist interventions (those not categorized as medication errors in the primary study) over a specified four-month period to identify "quality interventions" (QIs), defined as those that (1) prevented misuse, underuse, or overuse of medications or (2) improved adherence to quality standards or evidence-based medicine (EBM) standards. The study included an evaluation of the medication classes associated with QIs and the acceptance of pharmacist-recommended QIs. The reviewers identified a total of 91 pharmacist QIs at the four sites during the study period (2.3 QIs per 100 patients or about 1 QI per 100 medication orders). About 45% of the identified QIs improved adherence with EBM or national quality standards; other QIs prevented medication underuse (34%), misuse (14%), or overuse (6%). Pharmacists' QIs most often pertained to antiinfective agents (39%), cardiovascular agents (13%), and anticoagulants and thrombolytics (12%). The overall rate of acceptance of pharmacists' QIs was 93.4%. A secondary analysis of data from a previously published study at four medical centers indicated that ED pharmacists often recommend interventions that improve the quality of medication use and adherence to EBM and national quality standards.
    American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists 12/2011; 68(23):2271-5. · 2.10 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To understand how the source of information affects different adverse event (AE) surveillance methods. Retrospective analysis of inpatient adverse drug events (ADEs) and hospital-associated infections (HAIs) detected by either a computerized surveillance system (CSS) or manual chart review (MCR). Descriptive analysis of events detected using the two methods by type of AE, type of information about the AE, and sources of the information. CSS detected more HAIs than MCR (92% vs 34%); however, a similar number of ADEs was detected by both systems (52% vs 51%). The agreement between systems was greater for HAIs than ADEs (26% vs 3%). The CSS missed events that did not have information in coded format or that were described only in physician narratives. The MCR detected events missed by CSS using information in physician narratives. Discharge summaries were more likely to contain information about AEs than any other type of physician narrative, followed by emergency department reports for HAIs and general consult notes for ADEs. Some ADEs found by MCR were detected by CSS but not verified by a clinician. Inability to distinguish between CSS false positives and suspected AEs for cases in which the clinician did not document their assessment in the CSS. The effect that information source has on different surveillance methods depends on the type of AE. Integrating information from physician narratives with CSS using natural language processing would improve the detection of ADEs more than HAIs.
    Journal of the American Medical Informatics Association 07/2011; 18(4):491-7. · 3.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care.
    Chest 07/2011; 140(1):230-8. · 5.85 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To report the frequency, types, and causes of errors associated with outpatient computer-generated prescriptions, and to develop a framework to classify these errors to determine which strategies have greatest potential for preventing them. This is a retrospective cohort study of 3850 computer-generated prescriptions received by a commercial outpatient pharmacy chain across three states over 4 weeks in 2008. A clinician panel reviewed the prescriptions using a previously described method to identify and classify medication errors. Primary outcomes were the incidence of medication errors; potential adverse drug events, defined as errors with potential for harm; and rate of prescribing errors by error type and by prescribing system. Of 3850 prescriptions, 452 (11.7%) contained 466 total errors, of which 163 (35.0%) were considered potential adverse drug events. Error rates varied by computerized prescribing system, from 5.1% to 37.5%. The most common error was omitted information (60.7% of all errors). About one in 10 computer-generated prescriptions included at least one error, of which a third had potential for harm. This is consistent with the literature on manual handwritten prescription error rates. The number, type, and severity of errors varied by computerized prescribing system, suggesting that some systems may be better at preventing errors than others. Implementing a computerized prescribing system without comprehensive functionality and processes in place to ensure meaningful system use does not decrease medication errors. The authors offer targeted recommendations on improving computerized prescribing systems to prevent errors.
    Journal of the American Medical Informatics Association 06/2011; 18(6):767-73. · 3.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The addition of electronic prescription transmission to computerized prescriber order entry (CPOE) and its effect on dispensing errors in community pharmacies were evaluated. A controlled, before-and-after trial to measure the effect of electronic prescribing on dispensing errors in two control clinics and one e-prescribing clinic already using CPOE was conducted between January and November 2006. Prescriptions documented within the CPOE system were reconciled with dispensed prescription information from participating pharmacy chains via a national pharmacy information exchange network. Dispensing errors were defined as discrepancies between the prescriber's written orders and the dispensed prescription information. Prescriptions filled at nonparticipating pharmacies were not analyzed. A total of 11,447 prescriptions were written in the control clinics, and 29,575 were written in the e-prescribing clinic. During the intervention period, 2,179 (22%) of 9,905 intervention clinic prescriptions were electronically transmitted, including 621 (28%) available for analysis. There was no significant difference in the dispensing-error rates between the baseline and intervention periods for the control clinics. Similarly, the dispensing-error rates did not differ significantly for the e-prescribing clinic between the baseline and intervention periods for prescriptions that were not electronically transmitted. The e-prescribing clinic's dispensing-error rate for electronically transmitted prescriptions during the intervention was significantly lower than its baseline dispensing-error rate (p = 0.03). Electronic transmission of prescription data from physicians' offices to a pharmacy nearly halved the risk of dispensing errors compared with generating the prescription with outpatient CPOE and printing it and giving it to the patient.
    American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists 01/2011; 68(2):158-63. · 2.10 Impact Factor
  • Patricia C Dykes, Jeffrey M Rothschild, Ann C Hurley
    [Show abstract] [Hide abstract]
    ABSTRACT: To describe the development and psychometric testing of the Recovered Medical Error Inventory (RMEI). Content analysis of structured interviews with expert critical care registered nurses (CCRNs) was used to empirically derive a 25-item RMEI. The RMEI was pilot tested with 345 CCRNs. The data set was randomly divided to use the first half for reliability testing and the second half for validation. A principal components analysis with Varimax rotation was conducted. Cronbach's alpha values were examined. A t test and Pearson correlation were used to compare scores of the two samples. The RMEI consists of 25 items and two subscales. Evidence for initial reliability includes a total scale alpha of .9 and subscale alpha coefficients of .88 (mistake) and .75 (poor judgment). The RMEI subscales have satisfactory internal consistency reliability and evidence for construct validity. Additional testing is warranted. A tool to measure CCRNs' experiences with recovering medical errors allows quantification of nurse surveillance in promoting safe care and preventing unreimbursed hospital costs for treating nosocomial events.
    Journal of Nursing Scholarship 09/2010; 42(3):314-8. · 1.61 Impact Factor
  • Source
    Sandra L Kane-Gill, Judith Jacobi, Jeffrey M Rothschild
    [Show abstract] [Hide abstract]
    ABSTRACT: Advances in diagnostic tests, technological interventions, and pharmacotherapy have resulted in spectacular results for many intensive care unit (ICU) patients who, in earlier generations, would have succumbed to their critical illness. At the same time, the complexity and intensity of care required for ICU patients is also associated with greater risks for harm resulting from care. As in other inpatient areas, medications are the most common type of therapy in ICUs and are also associated with the most frequent type of ICU adverse events. Critically ill patients are at high risk for adverse drug events for many reasons, including the complexity of their disease that creates challenges in drug dosing, their vulnerability to rapid changes in pharmacotherapy, the intensive care environment providing ample distractions and opportunity for error, the administration of complex drug regimens, the numerous high-alert medications that they receive, and the mode of drug administration. The clinical outcomes of adverse drug events can result in end-organ damage and even death. The costs of an adverse drug event can be substantial to healthcare systems with an additional $6,000-$9,000 for each event. The multiprofessional patient care team is one approach to promoting patient safety in the ICU.
    Critical care medicine 06/2010; 38(6 Suppl):S83-9. · 6.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Early warning criteria ("criteria"), used to activate rapid response system (RRS) teams, may improve patient outcomes by predicting life-threatening adverse events--urgent intensive care unit (ICU) transfers and cardiac arrests. We conducted a case-control study on medicine patients in an academic medical center from May 2005 to June 2006. Controls were matched to RRS activation patients by admission date and unit. Rapid response system activation patients were then excluded from analysis. Chart reviews identified positive criteria on non-RRS patients. For controls, physiologic data were collected from admission until the day of matched RRS activations. Data were collected in patients with adverse events for the 8 hours preceding events. A total of 262 patients (2.8%) had 271 adverse events including 245 ICU transfers and 26 arrests. Positive criteria were found during 21.1% of control admissions (68/323). Positive criteria preceded 60.8% of the ICU transfers (158/260; 95% confidence interval, 54.8%-66.7%). However, 76.9% of patients with an arrest did not have previous positive criteria (20/26; 95% confidence interval, 60.7%-93.1%). Intensive care unit transfers with positive criteria were more likely to die than patients without criteria (35.4% versus 20.6%; odds ratio [OR], 2.1). Positive criteria most strongly associated with life-threatening adverse events were tachypnea (OR, 31.1) and 100% supplemental oxygen (OR, 13.7). The early warning conditions used to activate RRS teams were only fair predictors of acute deterioration, although early signs of respiratory failure during routine monitoring were strongly associated with future life-threatening adverse events. Improved respiratory monitoring may improve outcomes from RRS interventions.
    Journal of Patient Safety 06/2010; 6(2):97-101.
  • Patricia C Dykes, Jeffrey M Rothschild, Ann C Hurley
    [Show abstract] [Hide abstract]
    ABSTRACT: : The frequency and types of medical errors are well documented, but less is known about potential errors that were intercepted by nurses. We studied the type, frequency, and potential harm of recovered medical errors reported by critical care registered nurses (CCRNs) during the previous year. : Nurses are known to protect patients from harm. Several studies on medical errors found that there would have been more medical errors reaching the patient had not potential errors been caught earlier by nurses. : The Recovered Medical Error Inventory, a 25-item empirically derived and internally consistent (alpha =.90) list of medical errors, was posted on the Internet. Participants were recruited via e-mail and healthcare-related listservs using a nonprobability snowball sampling technique. Investigators e-mailed contacts working in hospitals or who managed healthcare-related listservs and asked the contacts to pass the link on to others with contacts in acute care settings. : During 1 year, 345 CCRNs reported that they recovered 18,578 medical errors, of which they rated 4,183 as potentially lethal. : Surveillance, clinical judgment, and interventions by CCRNs to identify, interrupt, and correct medical errors protected seriously ill patients from harm.
    The Journal of nursing administration 05/2010; 40(5):241-6. · 1.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code verification technology within an electronic medication-administration system (bar-code eMAR). We conducted a before-and-after, quasi-experimental study in an academic medical center that was implementing the bar-code eMAR. We assessed rates of errors in order transcription and medication administration on units before and after implementation of the bar-code eMAR. Errors that involved early or late administration of medications were classified as timing errors and all others as nontiming errors. Two clinicians reviewed the errors to determine their potential to harm patients and classified those that could be harmful as potential adverse drug events. We observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate)--a 41.4% relative reduction in errors (P<0.001). The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). The rate of timing errors in medication administration fell by 27.3% (P<0.001), but the rate of potential adverse drug events associated with timing errors did not change significantly. Transcription errors occurred at a rate of 6.1% on units that did not use the bar-code eMAR but were completely eliminated on units that did use it. Use of the bar-code eMAR substantially reduced the rate of errors in order transcription and in medication administration as well as potential adverse drug events, although it did not eliminate such errors. Our data show that the bar-code eMAR is an important intervention to improve medication safety. (ClinicalTrials.gov number, NCT00243373.)
    New England Journal of Medicine 05/2010; 362(18):1698-707. · 51.66 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study compared physicians' perceptions of the importance, accessibility, and quality of different types of patient information that could potentially be available with Health Information Exchange (HIE) with how they use patient information. The results showed that while the physicians rated the majority of 11 data types as very important, accessible, and of high quality, they regularly used only a few data types before having access to a new HIE system. The three major types of information regularly used by the physicians were diagnoses, current medication lists, and allergy information. This study provides new data about how opinions on the importance of information relate to reported information use. Our findings suggest that having important, accessible, and high quality information does not necessarily lead to routine use, but that much of the early value of HIE may lie in improving access to a few data areas.
    AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 01/2010; 2010:46-50.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Electronic patient tracking and records systems in emergency departments often connect to hospital information systems, ambulatory patient records and ancillary systems. The networked systems may not be fully interoperable and clinicians need to access data through different interfaces. This study was conducted to describe the interactive behavior of clinicians working with partially interoperable clinical information systems. We performed 78 hours of observation at two emergency departments, shadowing five physicians, ten nurses and four administrative staff. Actions related to viewing or recording data in any system or on paper were recorded. Collected data were compared along clinical roles and contrasted with findings across the two hospital sites. The findings suggest that differences in the levels of interoperability may affect the ways physicians and nurses interact with the systems. When tradeoffs in functionality are necessary for connecting ancillary systems, the effects on clinicians and staff need to be considered.
    AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium 01/2010; 2010:311-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We assess the impact of emergency department (ED) pharmacists on reducing potentially harmful medication errors. We conducted this observational study in 4 academic EDs. Trained pharmacy residents observed a convenience sample of ED pharmacists' activities. The primary outcome was medication errors recovered by pharmacists, including errors intercepted before reaching the patient (near miss or potential adverse drug event), caught after reaching the patient but before causing harm (mitigated adverse drug event), or caught after some harm but before further or worsening harm (ameliorated adverse drug event). Pairs of physician and pharmacist reviewers confirmed recovered medication errors and assessed their potential for harm. Observers were unblinded and clinical outcomes were not evaluated. We conducted 226 observation sessions spanning 787 hours and observed pharmacists reviewing 17,320 medications ordered or administered to 6,471 patients. We identified 504 recovered medication errors, or 7.8 per 100 patients and 2.9 per 100 medications. Most of the recovered medication errors were intercepted potential adverse drug events (90.3%), with fewer mitigated adverse drug events (3.9%) and ameliorated adverse drug events (0.2%). The potential severities of the recovered errors were most often serious (47.8%) or significant (36.2%). The most common medication classes associated with recovered medication errors were antimicrobial agents (32.1%), central nervous system agents (16.2%), and anticoagulant and thrombolytic agents (14.1%). The most common error types were dosing errors, drug omission, and wrong frequency errors. ED pharmacists can identify and prevent potentially harmful medication errors. Controlled trials are necessary to determine the net costs and benefits of ED pharmacist staffing on safety, quality, and costs, especially important considerations for smaller EDs and pharmacy departments.
    Annals of emergency medicine 12/2009; 55(6):513-21. · 4.23 Impact Factor

Publication Stats

3k Citations
485.65 Total Impact Points

Institutions

  • 2007–2013
    • Massachusetts General Hospital
      Boston, Massachusetts, United States
  • 2000–2013
    • Brigham and Women's Hospital
      • • Division of General Internal Medicine and Primary Care
      • • Department of Medicine
      • • Center for Brain Mind Medicine
      Boston, Massachusetts, United States
  • 2012
    • Massachusetts College of Pharmacy and Health Sciences
      Boston, Massachusetts, United States
  • 2010–2012
    • University of Pittsburgh
      • School of Pharmacy
      Pittsburgh, PA, United States
  • 2005–2012
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States
  • 2011
    • Cedars-Sinai Medical Center
      • Cedars Sinai Medical Center
      Los Angeles, CA, United States
  • 2002–2009
    • Partners HealthCare
      • Clinical Informatics Research and Development
      Boston, Massachusetts, United States
  • 2006
    • Cambridge Health Alliance
      • Department of Medicine
      Cambridge, MA, United States
  • 2003–2004
    • University of Massachusetts Medical School
      • Meyers Primary Care Institute
      Worcester, MA, United States