Medication Safety Unit Programs in King Saud Medical City, 2012 – 2013: Safe Medication Management and Use with a Focus on Patient Safety.

Background: Medication safety unit [MSU] streamlines the safe management and use of prescribed medications and reduction in all types of medication errors [MEs], and associated morbidity and mortality resulting in enhanced patient safety, better quality of healthcare services and cost saving. Objective: This study aims to describe MSU programs together with their purposes developed in King Saud Medical City [KSMC], Saudi Arabia and supports them with related policies and guidelines based on qualitative evidence-based research done across the world. Methods: A mixed study was designed to define programs, roles and annual plan of MSU, which was established in year 2012. Multiple awareness campaigns and training courses were organized for highlighting the significance of MSU among healthcare providers and consumers in KSMC. Results: The MSU developed 14 programs and annual medication safety plan of actions together with respective policies, procedures and guidelines, well supported by qualitative evidence-based research data for improving safe medication management and use associated with reported reduction in MEs, and increased patient safety and quality of healthcare. Conclusion: MSU is a useful tool to encourage reporting of MEs, which are reported to increase patient safety and safe medication management and tends to decrease the number of MEs. Beside establishing MSU in all hospitals, this study calls for a randomized controlled study in future that will identify potential risk factors that impact safe medication management and are associated with patient safety not only in Saudi Arabia but also in other Arabian Gulf countries.

A Comparative Analysis of Electronic Prescribing Near Misses in King Saud Medical City, Riyadh, Saudi Arabia.

Background: A “near miss” or close call is a medication error that happened but did not result in injury or damage to the patient. These medication errors (MEs) are captured and corrected before affecting the patient either fortuitously or purposefully by designed system controls imbedded in electronic health record (EHR) as well as electronic prescribing systems (EPS). Objective: This study analyzed the reported electronic prescribing near misses (NMs) in King Saud Medical City (KSMC) in Riyadh city. Methods: The ME report forms were consecutively collected over a period of one year, from 1 January to 31 December, 2012. These forms were evaluated for data abstraction and a comparative analysis of NMs/NM report forms of first 6-month (n=1025, timeline 1) versus second 6-month (n=2398, timeline 2) was carried out. No systematic intervention prior to timeline 2 was used in this study. Results: The total number of MEs/NMs report forms was 3423 and total number of reported NMs was 7415, as each form could contain more than one NM. Drug prescription items, medication dispensing stages, NM makers and identifiers, underlying causes, sites of errors, prescribed drugs and suggested actions to avoid NM errors all differed significantly between the two timelines, which could be attributed to natural, real world practices in KSMC. Conclusion: This prospective study found significant differences in factors related to NMs between two six month periods in a single year. Reasons for these differences between two timeframes remain poorly understood. NMs comparative studies using systematic interventions are warranted in the Kingdom of Saudi Arabia.