Multidisciplinary Approach
In its 2001 report “Crossing the Quality Chasm: A New Health System of the 21st Century,” the U.S. Institute of Medicine declared: “The current care systems cannot do the job. Trying harder will not work. If we want safer, higher-quality care, we will need to have redesigned systems of care, including the use of information technology to support clinical and administrative processes.”
While hospitalists are on the front line for preventing adverse drug reactions, they can’t do it by themselves. Here are a few tips for making your job easier:
Request that medications inappropriate for geriatric patients (based on the Beers criteria) be notated as such by the pharmacist;
Ask for a geriatric dosing option in the computer-based medication ordering system;
Flag charts of patients with previous adverse drug effects with the name of the offending drug;
Warn nurses and other caregivers to monitor for specific side effects; and
Advocate that midlevel providers receive hospital-based training in the prevention of medication-related adverse events.
The elderly portion of the population is expanding more rapidly than the population as a whole, and the recognition and prevention of medication side effects in this group is one of the most critical safety and economic issues facing the healthcare system today. While the magnitude of this problem demands multidisciplinary involvement, hospitalists can be key players in making a difference