Impact of Technology on Quality & Safety Initiatives

Dual Sign Levels of Dual Sign at MetroHealth Why Dual Sign? Joint Commission and Institute for Safe Medication Practices require dual signoff for high-alert medications Patient Safety with High Risk Drugs Nationwide Approaches to improve safety Medication Level (ERX) Medication in all locations Heparin Profile Level Nursing Students Department Level – Global Medications given at a certain area - NICU Department – Drug Specific Certain medications Certain departments MAR Action – Exclusions Specific Mar actions can be excluded from requirement

!! Symbol = Dual Signoff Required

Outcomes: Significant Heparin Errors

Barcode Medication Administration: BCMA Why BCMA? Patient Safety Initiative U.S Department of Health & Human Services “Errors associated with medications are the most frequent cause of adverse medical events” Meaningful Use: Stage 2 Requirement HIMSS Stage 6 Closed loop mediation administration HIMSS Stage 7: Expressed Breast Milk Blood Products

Patient & Medication Scanning Compliance

Best Practice Alerts: BPA What are BPAs? MetroHealth Examples Provide targeted, patient-specific clinical guidance to end-users Versatile decision support tool Scan patient’s entire record Display notifications based on key pieces of clinical data Lab results Assessment data Medications Diagnoses Histories Include links to actions Order placement Care plans Ebola Screening Identifying patient’s at risk Alerting clinical team members Immunizations Screening reminders Order placement Administration reminders Heart Failure Discharge Instructions Reminder based on Problem List VTE Risk Assessment Assessment reminder Contraindication documentation Restraints Incorporate Care Plan