Background An internal audit at a surgical ward showed that the medication process is not adequate in terms of efficiency and safety. At the time of transfer of the patient from the emergency department (ED) to the ward, home medication is often unknown or incomplete. Furthermore, the medication is prescribed using a different medium at the ED compared with the other wards (on paper vs electronic). Both processes can easily cause medication errors.

Purpose The purpose was to create a safe, efficient and continuous medication process for hospitalised patients, starting at the ED. By creating a multidisciplinary team (physicians, nurses and pharmacists), we obtained a fully known and reviewed medication therapy that was electronically prescribed and validated at the time of transfer of the patient from the ED to the ward.

Material and methods To achieve this goal, 3 different projects were set up. Firstly, a computerised physician order entry (CPOE) coordinated by a pharmacist was started up at the ED. Secondly, the clinical pharmacist performed a reconciliation of the medication, followed by an appropriateness control of the therapy. Thirdly, faster delivery of medication to the ward was provided by changes in the practical organisation of the hospital pharmacy.

Results During the study period after the start up of the CPOE at the ED, there was an average validation rate by physician of 71%, and a median validation time of 2 hours 16 min. The validation rate during the weekends was lower than during the week but was not significantly different. The second project, the appropriateness control by a clinical pharmacist, showed an acceptance rate by the physicians of 77% of the pharmaceutical advices.

Conclusion We can conclude that enrolment of the CPOE and the multidisciplinary cooperation between physicians, nurses and pharmacists at the ED had a positive impact on the medication process in the hospital. The import of a CPOE at the ED provides a safer, more efficient and continuous medication process which improves the quality of the therapy.

References and/or acknowledgements

1. http://www.ihi.org/topics/adesmedicationreconciliation/Pages/default.aspx

2. De Winter S, Vanbrabant P, Spriet I, et al. Clinical pharmacy services at the emergency department.

References and/or acknowledgementsNo conflict of interest