A project sponsored by the Massachusetts State Office of Rural Health (MA SORH) is helping rural hospitals in the state learn how to reduce the possibility of medication-related patient harm. With the Medication Safety Performance Improvement Project, the MA SORH has contracted with the Institute for Safe Medication Practices (ISMP) to perform one-day targeted medication safety risk assessments at the hospitals.

ISMP recently started offering these one-day medication safety assessments with small and rural hospitals in mind.  Each hospital assessment visit focuses on one or two predetermined, mutually agreed upon topic areas in medication safety such as sterile compounding, oncology, medication use in the perioperative areas, or medication administration practices. The ISMP team meets with and interviews key hospital administrators, medical and clinical staff, and other hospital managers to gain an understanding of current medication use practices in the areas of focus. Although the hospital pharmacist takes the lead, it’s important that other hospital staff is included since they all have a role in medication safety, said Cathleen McElligott, director of the Massachusetts State Office of Rural Health.

At the conclusion of the visit, the ISMP team presents their findings through an interactive presentation. The focus of the presentation is to identify areas of risk exposure observed within the designated areas of focus and to make prioritized recommendations for change. Following the visit, ISMP creates a written report that describes specific medication safety recommendations and provides associated references and tools to assist with implementation of the safety strategies.

The project, which began in April of last year, has been piloted with four hospitals in the state. “It’s been so successful that we’re adding four more hospitals this spring,” McElligott said.

According to Ronnie Rom, MA Flex Coordinator, who began and now coordinates the pharmacy project, the facilities that have participated have noted significant improvements in medication storage, labeling, removal and verification processes. The project has also been a contributing factor to achieving 24/7 coverage sign-off at a couple of the facilities, Rom said. Participants have lauded the ISMP team for having “engaged hospital employees across disciplines and committees,” and for offering “concrete guidance to improve evaluation/measurement of patient safety.” In addition, Rom said, participants have shared that they have found it “especially helpful to have this opportunity be presented by the SORH as a healthy non-judgmental check-up vs. a problem-initiated visit.”

The New England Rural Health Roundtable provides reimbursement for the project with funds provided by the MA SORH’s Rural Hospital Flexibility Program. “We found the ISMP team highly professional and easy to work with,” Rom said. “We think other flex programs should take advantage of this,” McElligott added.



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