Patient Safety and Quality

Systems to detect adverse drug events need buy-in from leaders and staff to become part of hospital routine

Automated tools to detect adverse drug events (ADEs) are common research initiatives at hospitals, but these efforts seldom endure, because sustaining them is rarely a project goal. However, a team at Duke University Health System successfully transitioned a research project for computerized detection of ADEs into hospital practice by involving hospital staff throughout the project.

Researchers based at the Duke University Health System implemented the ADE surveillance (ADE-S) system at three hospitals in three phases. The first phase, development of the ADE-S based on the hospitals' clinical data systems, was funded by a grant from the Agency for Healthcare Research and Quality (AHRQ) and began in December 2004. The hospitals funded the two subsequent phases that aimed to refine and sustain the ADE-S. The sustainment effort is ongoing.

The authors offer several recommendations for other organizations attempting to implement and sustain similar surveillance programs in hospitals. They stress the need for research teams to appreciate fully the hospital's resources and workflow to ensure clinical staff can review the flagged ADEs easily. Aligning the hospital's priorities for which ADEs should be detected as well as including clinical staff in developing the systems will also help with staff buy-in for the project. Finally, ensuring the ADE-S system data are accessibly formatted and are not duplicative will help staff streamline their work and ensure the data are useful for the hospital's quality improvement efforts. This study was funded in part by AHRQ (HS14882).

See "Culture counts—Sustainable inpatient computerized surveillance across Duke University Health System," by Heidi Cozart, R.Ph., Monica M. Horvath, Ph.D., Andrea Long, Pharm.D., and others in the October-December 2010 Quality Management in Health Care 19(4), pp. 282-291.

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