CMH ranks second in medication safety statewide

Calvert Memorial ranks second in medication safety statewide, according to a recent survey of 46 Maryland hospitals. The survey, conducted annually by the Maryland Patient Safety Center, helps facilities target areas for improvement.

Locally, CMH has made fundamental changes in the way medications are ordered, stored, dispensed and administered. It has also increased its pharmacy staff. To an increasing degree, the hospital is focusing on computerized systems that prevent errors, especially those created by poor handwriting and abbreviations.

“These changes are having a positive impact,” said CMH President and CEO James Xinis. “They are improving patient safety … and that is our first priority.”

The in-depth survey, which contains 231 questions, looks at how well each facility practices medication safety. It examines key elements such as patient information, staff education and drug communication, as well as labeling, monitoring and delivery devices.

The maximum possible score is 1,484. Calvert’s total score was 1,326 or 89 percent. This surpassed the statewide median of 1,164.5 or 78.5 percent. CMH topped other hospitals of similar size (100-299 beds) and rural facilities, which reported median scores of 79.7 percent and 78.8 percent, respectively.

The survey is part of the MEDSAFE Project, a collaborative effort between the Maryland Hospital Association and the Delmarva Foundation. The report’s findings are released to the individual hospitals with a detailed analysis that helps them set priorities for the coming year.

This strategy has been effective at CMH who has posted steady gains in the past three years – from seventh in 2004, to sixth last year and second in the most recent survey.

“It’s a group effort,” said CMH Pharmacy Directory Vince Jackson. “We have all the key players on our (medication safety) team. We focus on ways to improve medication safety and it’s worked.”

A few of these improvements are highlighted here:

Medication Prescribing – CMH has developed preprinted order sets that have proven effective in reducing errors. The standardized orders are used for high-risk, high-volume drugs like insulin and blood thinners. These forms specify how the medication is given and monitored, predefine doses and list safety issues and additional therapies.

Medication Dispensing – CMH uses an automated medication system (called Pyxis) to ensure that patients receive the appropriate dose of the correct medication at the proper time – a key safety measure.

Medication Monitoring – Additional pharmacists were hired to make a 24-hour pharmacy an important reality at CMH. The increased hours and services are having a positive effect on patient safety.

Medication Administration – In 2005, CMH piloted an electronic VMAR (Virtual Medication Administration Record) to replace the traditional paper form. The new on-line record saves time and reduces errors. The system is currently in use on levels 2, 3 and 4, the Infusion Therapy Center and respiratory department. This fall, it will be added to the Family Birth Center and level 5.

This fall, CMH will implement a medication bar coding system.  At the bedside, staff will use advanced bar coding – the same technology used on everything from groceries to concert tickets –to verify that they’re giving the right patient the right dose of the right drug via the right route at the right time. 

Today, every patient wears and ID band with his or her name on it as well as a bar code.  This bar code will be used to match and monitor the medication ordered by the patient’s doctor.  Before administering medications, nurses and other caregivers will scan the bar code on the patient’s ID band and on the medications using a hand-held device.

Through immediate feedback on a bedside computer, the nurse or caregiver will be alerted to any potential errors and other critical information that could prevent adverse drug effects.

Also on the drawing board is computerized physician order entry (CPOE), which offers additional built-in safeguards to prevent mistakes. It is estimated that CMH will spend $5 million over the next several years to install new information technology that will mean even better patient safety.