oa Reducing errors in medication order prescription for in-patients by pediatric physicians: A step towards effective patient care

Background: In the data collected in the Hamad General Hospital (HGH), general pediatric in-patient unit, it was found that only 58% of medication orders were correctly prescribed by the resident physicians. This leads to patient care delays in a critical context and affects the discharge process^1,2.

By placing the correct order of medications, medication errors can be reduced. It prevents unnecessary calls being made to physicians by nurses and frequent calls from the pharmacy for verification in the pediatric in-patient unit, thus avoiding delays in-patient care. A quality improvement project was initiated in the pediatric in-patient unit, to improve the rate of correct medication prescriptions by pediatric resident physicians from 58% in February 2021 to 90 % by September 2021. Methods: Two main categories of change ideas were identified. Firstly, education and awareness, and secondly communication. For the two main change ideas, from April to September 2021, 7 Plan, Do, Study, Act (PDSA) cycles were conducted, each cycle with a different change idea (Figure 1). Educational sessions were implemented for resident physicians. Visual reminders were displayed on Workstation on wheels (WOW), educational material was posted in the residents’ lounge, weekly reminders were given through morning reports, monthly reminders were sent through e-mail, and twice-monthly updates were provided by the clinical pharmacist³. Results: There has been a gradual improvement in the percentage of correct medication order prescriptions from a baseline of 58% in February 2021 to 90% in September 2021 (Figure 2), hence meeting the objective of this quality improvement project. Conclusion: Gradual improvement was found in the medication order prescription by the pediatric physicians in the HGH pediatric in-patient unit from February 2021 to September 2021.

Introducing stickers on WOW highlighting awareness for orders created a positive impact on the residents while placing the orders. This positive outcome is expected to be sustained by regular performance monitoring and corresponding remediation interventions.