Technology and Error in the U.S.A. David W. Bates, Medical Director of Clinical and Quality Analysis, Partners Healthcare Chief, Division of General Medicine, Brigham and Women’s Hospital. Overview. Nature/scope Costs Impact/potential of IS CPOE Bar-coding Smart pumps
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David W. Bates,
Medical Director of Clinical and Quality Analysis, Partners Healthcare
Chief, Division of General Medicine,
Brigham and Women’s Hospital
“Indeed, between the health care that we now have, and the health care we could have, lies not just a gap, but a chasm.” Crossing the Quality Chasm: A New Health System for the 21st Century
In 10,070 Orders
530 Medication Errors 1.4 per admission
35 Potential ADEs
5 Preventable ADEs
Forster et al, Ann Intern Med, 2003
Gandhi et al. JGIM 2000
Jha, et al. Ann Pharmacother, 2001
Bates and Gawande, NEJM 2003
Drug-allergy Dose ceiling Drug-lab
Effect of real-time decision support for patients with renal insufficiency
Dose 54% 67%
Frequency 35% 59%
Chertow et al, JAMA 2001
ISMP Newsletter Feb 6, 2002
Leape, JAMA, 2000
David W. Bates, M.D.
David Blumenthal, M.D.
Eric Campbell, Ph.D.
E. Francis Cook, Sc.D.
Allan Frankel, M.D.
Jerry Gurwitz, M.D.
Rainu Kaushal, M.D.
Carol Keohane, R.N.
Barry Kitch, M.D.
Lucian Leape, M.D.
Jeffrey Rothschild, M.D.
Safe Intravenous Infusion Systems
Ambulatory Pediatric Epidemiology Study
Inpatient Psychiatric Epidemiology Study
Organizational culture in promoting patient safety
Improving Safety in Nursing Homes
Study a variety of clinical settings
Eliminate gaps in ME research
Improve Medication Safety Across Clinical Settings
Develop strategies to improve patient safety
Translate new strategies to an array of settings
“I don’t want to make the wrong mistake.”