Pharmacy Practice

We Can Optimize Medication Use to Improve Outcomes

Published: November 3, 2023
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Despite advancements in healthcare technology and medication safeguards, medical errors continue to occur at a high rate within health systems. A recent study led by Bates and published in the New England Journal of Medicine helped quantify the landscape of medication safety within inpatient sites. Bates and colleagues analyzed data from 11 Massachusetts hospitals and more than 2,800 random admissions during 2018.

The most common type of adverse event was an adverse drug event, followed closely by surgical or other procedural events. The authors also found that adverse events were higher among older patients and men. Event rates were noted to be higher at larger hospitals.

The study’s limitations included a low population of Medicaid and uninsured patients and study sites confined to small geographic areas. But the study is notable as a comprehensive, critical examination of adverse events from multiple sites and as a follow-up to the landmark Harvard Medical Practice Study in 1991.

The findings of the Bates study indicate that individual hospitals and the healthcare system at large continue to have room for improvement regarding patient safety and delivery of care. The authors noted a few key elements are essential to enhance safety standards within an organization:

  • Accurate and appropriate measurement of adverse events for organizations, which can often be complex to achieve, is an initial step to improving safety
  • Appropriate safety culture
  • Dedicated leadership




Given the impact on overall patient care, improving medication safety should be a top priority for organizations. While a multitargeted approach to improvement should be implemented, one recommended avenue can be through staff education and training. Medication safety training can help staff remain up to date in their knowledge and skills by educating on the latest medication use standards.

Ensuring staff are trained on key medication safety concepts can help optimize medication use and elevate the care provided to patients. Competency training also allows staff to receive a refresher on fundamental topics and assimilate new knowledge on changes in safe medication use standards. Training can also be tailored to the specific roles and responsibilities and individual needs of a staff member.

Medication safety foundational knowledge and ongoing competency training can be valuable tools to not only help improve outcomes, but also provide continuous professional development for staff. ASHP has developed a full suite of medication safety educational materials for pharmacists and pharmacy technicians.

Learn more about ASHP’s Medication Safety Resources:

Posted November 3, 2023

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