Repeat After Me: Simple Change Cuts Medical Errors

Having doctor's orders repeated back ensures patient safety, study finds

MONDAY, May 1, 2006 (HealthDay News) -- A simple change in the way doctors' verbal medical orders are entered into a computerized physician order-entry system reduced errors to zero, a new study found.

"By simply having the resident read back the order before he or she entered it into the computer, we reduced verbal order errors from 9.1 percent to zero. Although this was a small study, these results are very encouraging," main author and pediatrician Dr. Michael Vossmeyer said in a prepared statement.

During rounds at Cincinnati Children's Hospital Medical Center, orders are entered into the computer system right at the patient's bedside. The order is verbally communicated by the attending physician or chief resident and a resident physician then enters the order into the computer system.

In the first part of this study, the team on rounds took 70 consecutive orders. After rounds, they examined the orders and found a 9.1 percent error rate, mostly in drug dosages that would not have affected patient safety. However, in two instances, the resident wrote down the wrong drug.

The researchers then implemented a process where the resident reads back the order to the attending physician or chief resident for verification before it's entered into the computer system. This approach was tested in 75 orders, and there were no errors.

The process adds only a few seconds to each visit to a patient's room, so it does not slow down rounds.

"We're doing a follow-up study to determine if the results are sustainable and the process is reliable, but they appear to be very generalizable. That's particularly important to tertiary patients, such as children with organ transplants, where proper doses mean so much," Vossmeyer said.

The study was to have been presented Saturday at the Pediatric Academic Societies annual meeting, in San Francisco.

More information

The U.S. Food and Drug Administration has more about medical errors.

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