Tidelands Health leveraging new software to improve patient safety

When it comes to medication prescriptions, decimal points matter. Put one in the wrong spot, and a patient can receive 10 times too much – or too little – of a drug.

That’s one of the reasons why Tidelands Health has adopted innovative real-time surveillance software in its inpatient hospital pharmacies. The goal is to help prevent prescription drug errors, improve patient safety and quality of care.

Preventing medication errors has long stood atop the list of priorities within the medical community, and for good reason. The Food and Drug Administration estimates that medication errors kill at least one person per day and injure approximately 1.3 million people annually in the United States.

That’s not just in hospitals. Mistakes can happen almost anywhere, including homes, doctors’ offices, pharmacies and senior living facilities. It’s as simple as inadvertently taking two medications with different names that contain the same drug.

Even though the number of medication errors is relatively small compared to the volume of prescriptions dispensed each year, the problem is rightfully targeted because medication errors are preventable.

In South Carolina, nearly 66 million prescriptions were dispensed in 2015, according to the Henry J. Kaiser Family Foundation. Nationwide, the total stood at nearly 4.1 billion.

Tidelands Health has always embraced industry best practices to help prevent medication errors in its hospitals and medical practices. Its physicians, nurses and pharmacists follow an extensive series of checks and balances to help ensure each patient receives the right medicine, at the correct dose and at the appropriate time.

The forward march of technology has introduced new tools that add even greater resilience to safety measures.

In October 2014, the health system began using Truven Health’s Micromedex Pharmacy Intervention system, which can alert pharmacists, for example, of an irregularity in the size of a dose, in the case of duplicate prescriptions or if there are concerns about drug interactions or overlaps.

The system is constantly updated to account for new medications or to address specific needs within the hospitals, said Kelly Edwards, assistant director of inpatient pharmacy services for Tidelands Health. Although pharmacists personally review each prescription before it is filled, the Truven software serves as a backstop against errors and makes filling prescriptions more efficient.

“The software has really revolutionized the way we operate,” Edwards said. “It’s an incredibly powerful tool that only gets stronger over time.”

One of the software’s biggest benefits is its ability to help ensure pharmacists are aware when existing prescriptions need to be changed because of fluctuations in a patient’s condition, said Darrell Willm, director of inpatient pharmacy services. For example, a patient’s kidney function or weight can change while in the hospital.

Physicians and pharmacists actively monitor for those changes, he said, but the Truven system adds yet another layer of security.

The Truven software can also monitor lab and culture results in real time, said Kirsi Mathews, clinical pharmacy coordinator at Tidelands Waccamaw. This helps ensure prompt review of results so pharmacists can contact providers for new medication orders, if necessary.

But the Truven software is only one part of the health system’s much broader approach to medication safety, according to Edwards.

Those safety measures start when a physician first orders a prescription. To help reduce the risk of transcription errors, the health system offers a computerized order entry.

Upon receiving a prescription order, in-house pharmacists - with backup from the Truven system - review the request against the patient’s medical record to help ensure it’s safe and appropriate.

Before the drug is administered, nurses use a bar code system to help verify the medication is going to the right person.

Recognizing there’s always room for improvement, Tidelands Health has also focused on creating a culture that encourages its clinicians to report any areas of concern, said Chris Rees, associate vice president of safety, service excellence and physician services. Transparency allows the system to take prompt action to address any gaps.

“We can’t assume the practices we have in place today will prevent a mistake in the future,” Rees said. “As a result, we are constantly evaluating ourselves to look for ways to improve the safety and effectiveness of our care.”