The Impact of a Low-Technology Medication Organization System on Hospital-at-Home Medication Errors.

Abstract

Background: Hospital-at-home (HaH) programs provide hospital-level care in the home as an alternative to inpatient hospital stays. Because no standard system exists for storing and organizing medications during home hospitalization, the risk of medication errors and potential harm may be increased. The medication errors workgroup of an HaH program at a quaternary care academic medical center identified the need for a medication storage system to mitigate errors resulting from misplaced or misused medications.

Purpose: An interdisciplinary quality improvement (QI) project initiated by the medication errors workgroup aimed to support safe, patient-friendly medication management and reduce medication errors.

Methods: A low-technology medication storage system for HaH patients was designed and implemented in August 2022. Medication errors were compared before and after the intervention. A survey assessed patient and staff satisfaction with the storage system in the postintervention period.

Results: Unadjusted analysis showed that, among the 552 patients admitted to our HaH program during the study period (January through December 2022), the risk of medication error was significantly lower (odds ratio [OR], 0.55; P = 0.046) in the postintervention group (n = 260) than in the preintervention group (n = 292). After adjustment for age and HaH duration, the risk of medication error remained lower with use of the intervention (OR, 0.52; P = 0.03). Most patients and health care workers who participated in the satisfaction survey responded positively to the project.

Conclusion: HaH programs have unique risks for medication errors that require program-specific solutions. This QI project developed a medication storage system that improved HaH medication administration. These results are promising and may further improve medication management in the home.