A focused effort targeting people, processes and technology to improve closed-loop medication administration (CLMA) led to monthly rates consistently more than 95 percent at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada. The effort ensured technology supported the rights of medication administration, thereby reducing potential medication errors.
"Ultimately, all of this is about delivering safer and better patient care," said Heather Sulkers, senior director, enterprise project management office and clinical informatics. "It helps patients if providers and staff have access to information in a timely, accurate manner."
CLMA electronically tracks medication from prescription to administration and ensures patients receive the right medication while reducing the risk of errors. From June 2016 through April 2017, CAMH launched initiatives to improve medication administration. In order to reach its goal of achieving 95 percent CLMA, CAMH approached the project from several angles, including updating technology for barcode scanning, implementing mobile scanning options and ensuring machines could accurately read all barcodes.
"We worked to address and remove barriers, as well as ensured nursing staff were set up for successes while leveraging technology during medication administration," said Sulkers.
CAMH also re-educated staff on CLMA importance and encouraged them to increase adoption.
"We decided to make all our unit and individual CLMA rates transparent, so clinicians could see how their rates compared to their peers," said Damian Jankowicz, vice-president information management, chief information officer and chief privacy officer. "The idea was to create friendly competition that would encourage clinicians to change their behavior – and it worked."
The effort made a big difference. Previously, CLMA averaged around 62 percent monthly.1 However, from May 2017 through May 2018, CLMA rates rose to a monthly average of more than 98 percent.
CAMH also saw an increase in the number of alerts triggered that inform clinicians when a patient chart and an identification wristband did not correspond to one another. Staff avoided a monthly average of 836 potential medication errors after alerts fired,2 compared to 448 monthly alerts previously.3
"Cerner helped us get to HIMSS Stage 7 by providing us the platform for our electronic health record," said Sulkers. "It was the goal to have a fully-integrated electronic health record. It helps support and streamline care delivery, making sure we have one source of truth."
For more on how CAMH is using data to improve care, read their recent article in Perspectives.
1 April 2016 - June 2016
2 May 2017 - May 2018
3 April 2016 - June 2016