Medication Safety

One of Our Top Concerns

Whether a child has a chronic condition that requires regular treatment or only needs to take medicine for a short-term illness, managing kids’ medications is key to helping them be as healthy and safe as possible.

For starters, it’s important to make sure that you and all of your child’s health care providers are on the same page so medication errors are avoided.

Medication errors such as:
  • duplicating medicines: providing a medicine you might already have
  • giving the wrong dose: too much or not enough
  • experiencing dangerous drug interactions

At Nemours, one of our top priorities is ensuring that all of our patient-families and our physicians are sharing information about medications whenever a change is made. And we’re doing leaps and bounds better than the national goal for other children’s hospitals.

And every child’s medication needs vary; some might get none, others could require as many as eight different kinds of medicines every day. So managing kids’ medicines and making sure children are always getting the right kinds of medicines — whenever and however much they need — is complicated. That’s why it’s vital for us to work together as a coordinated team that incorporates the latest technology and our most important team members — you, the parents.

How We Do It

In order to improve medication safety and help families (as well as our older preteen and teen patients) understand how to manage medicines, we aim to:

  1. Ask you at the beginning of your family’s encounter with us about all the current medications your child is taking. Then our goal is to review that list with you to make sure that all recommended medicines are still appropriate.
  2. Keep track of and update the medications in our electronic medical record (EMR) so that our health care providers will know the type, dosage, and frequency of all of your child’s medications.
  3. Go over any changes in medications with you and your child and provide a new list at the end of the visit.

At Nemours, and nationally, this process is called medication reconciliation. It helps ensure that families like yours better understand which medicines their child should be taking, how much, and how often. It also helps use ensure that every health care provider is up to date on the current medications throughout your child’s care. This process has become an integral part of our quality patient care.

To keep improving, our goal is to consistently follow the process: to provide an updated medication list to our patient-families whenever a change is made to their child’s medicines. And our efforts show in our numbers.

Looking at all of our Nemours locations combined, we did 32% better at reviewing, updating, and sharing medications lists with our patients and families from 2008 to 2009. By the end of 2009 we’d given 83% of our patient-families an updated medication list. Pretty impressive, considering that the national goal is just 50%.

Why Our Electronic Medical Record Works So Well

Nemours is at the forefront of technological integration in the care of our patients, thanks to the development and use of our comprehensive, award-winning electronic medical record (called NemoursOne). In addition to unifying all of our physicians, researchers, and clinicians across locations and specialties, we’ve designed a system that connects referring physicians and patient-families so that every member of the care team can be informed at the same time and contribute to improving the health of the child at every step.

NemoursOne has drastically improved medication safety, in particular, throughout our health system. For one, our doctors are no longer writing prescriptions on a piece of a paper. They’re entering all prescriptions into the EMR, which then stores the information and gives you, the parent, a printed-out prescription instead of a handwritten one. And that means the pharmacist doesn’t have to try to interpret the health care provider’s writing.

The EMR also automatically checks:
  • dosages, to make sure they’re right, based on your child’s age and weight
  • possible negative interactions with other medications your child is taking
  • for any allergies to medications your child might have

Then the system alerts your child’s care team about any concerns and prevents any potential problems.

Working Hard to Sustain Our Medication Safety Success

Even though medication reconciliation is now a national safety goal, many hospitals struggle to accomplish this, let alone document it. But at Nemours, the process has become an expectation whenever we prescribe medications. We make it our goal to work with families to create the safest medication process while their children are in our care and when they’re back at home giving the medications on their own.

Each year, we aim to keep improving upon how we communicate with patients and families about medicines, as well as how we keep track of and update all medication changes. That means helping to keep the kids we see safer by reducing medication errors, and healthier because they’re taking the right medicines and the right amounts when they need them.

No matter how many or how few medications your child might need, we treat every child as we would our own — whatever it takes.