St. Joseph's Hospital & Candler Health System (SJCHS)

In 2006, the Institute of Medicine reported that among hospitalized patients at least 400,000 preventable adverse drug events (ADEs) occur annually with costs of $3.5 billion, or $8,750 per preventable ADE. Their recommended medication-error-prevention technologies include computerized prescriber order entry, bar-code medication administration, and computerized intravenous (IV) safety systems with dose-error-reduction software.

St. Joseph's Hospital and Candler Hospital, the two main facilities of SJCHS and two of the oldest continuously operating hospitals in the United States, was the first U.S. hospital system to replace its existing IV pumps for computerized "smart" PCA pumps. The decision to incur the incremental cost for changing technology resulted in financial benefits, improved safety, improved quality of care and increased nursing satisfaction.

Electronic data recorded at the bedside as caregivers administered medications provided information from which actual cost avoidance could be more readily calculated and provided objective evidence of the fiscal value of investments in innovative technologies. Over a five-year period, implementation of these “smart” systems reduced high-risk medication errors and patient-controlled analgesia-related undesired outcomes, helped avert at least 471 preventable ADEs, and provided a five-year return on investment (ROI) of $1.87 million, with an internal rate of return (IRR) of 81%. Financial analysis on the incremental costs of IV safety systems can help to more accurately calculate anticipated ROI and better prioritize IV safety system implementation.

Results

• Over a five-year period, implementation of these “smart” systems reduced high-risk medication errors and patient-controlled analgesia-related undesired outcomes, helped avert at least 471 preventable ADEs
• The implementation of a smart IV system reduced high-risk medication errors and provided a five-year return on investment (ROI) of $1.87 million and an internal rate of return (IRR) of 81%.

***Submitted by Ray R. Maddox, PharmD, Director, Clinical Pharmacy, Research & Pulmonary Medicine St. Joseph's/Candler Health System, Inc., MADDOXR@sjchs.org.

Published: January 26, 2009