Impact of Partnered Pharmacist Medication Charting (PPMC) on Medication Discrepancies and Errors: A Pragmatic Evaluation of an Emergency Department-Based Process Redesign

Tesfay Mehari Atey (), Gregory M. Peterson, Mohammed S. Salahudeen, Luke R. Bereznicki, Tom Simpson, Camille M. Boland, Ed Anderson, John R. Burgess, Emma J. Huckerby, Viet Tran and Barbara C. Wimmer
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Tesfay Mehari Atey: School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart 7005, Australia
Gregory M. Peterson: School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart 7005, Australia
Mohammed S. Salahudeen: School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart 7005, Australia
Luke R. Bereznicki: School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart 7005, Australia
Tom Simpson: Pharmacy Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart 7000, Australia
Camille M. Boland: Pharmacy Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart 7000, Australia
Ed Anderson: Pharmacy Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart 7000, Australia
John R. Burgess: Department of Endocrinology, Royal Hobart Hospital, Tasmanian Health Service, Hobart 7000, Australia
Emma J. Huckerby: Emergency Department, Royal Hobart Hospital, Tasmanian Health Service, Hobart 7000, Australia
Viet Tran: Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart 7000, Australia
Barbara C. Wimmer: School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart 7005, Australia

IJERPH, 2023, vol. 20, issue 2, 1-15

Abstract: Medication errors are more prevalent in settings with acutely ill patients and heavy workloads, such as in an emergency department (ED). A pragmatic, controlled study compared partnered pharmacist medication charting (PPMC) (pharmacist-documented best-possible medication history [BPMH] followed by clinical discussion between a pharmacist and medical officer to co-develop a treatment plan and chart medications) with early BPMH (pharmacist-documented BPMH followed by medical officer-led traditional medication charting) and usual care (traditional medication charting approach without a pharmacist-collected BPMH in ED). Medication discrepancies were undocumented differences between medication charts and medication reconciliation. An expert panel assessed the discrepancies’ clinical significance, with ‘unintentional’ discrepancies deemed ‘errors’. Fewer patients in the PPMC group had at least one error (3.5%; 95% confidence interval [CI]: 1.1% to 5.8%) than in the early BPMH (49.4%; 95% CI: 42.5% to 56.3%) and usual care group (61.4%; 95% CI: 56.3% to 66.7%). The number of patients who need to be treated with PPMC to prevent at least one high/extreme error was 4.6 (95% CI: 3.4 to 6.9) and 4.0 (95% CI: 3.1 to 5.3) compared to the early BPMH and usual care group, respectively. PPMC within ED, incorporating interdisciplinary discussion, reduced clinically significant errors compared to early BPMH or usual care.

Keywords: pharmacist; co-charting; medication charting; PPMC; emergency department; medication discrepancy; medication error (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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