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Strategies Aim to Reduce Harm to Patients

Deborah J. Neveleff

March 2003
Cover Story

As the occurrence of adverse events has gained attention recently, many organizations have developed strategies to measure and reduce medical errors. The Institute for Healthcare Improvement (IHI) and Premier Inc. have collaborated to develop the Idealized Design of the Medication System. IDMS focuses not on reducing the number of medical errors but on the harm that both errors and poor care systems can cause.
Created in 2000, IDMS is an initiative that measures and reduces the harm to patients caused by adverse drug events. Some 25 physicians, nurses, pharmacists, and statisticians are participating.
The IHI (at www.IHI.org), in Boston, is a nonprofit organization that helps lead the improvement of health care systems through developing and sharing best practices for quality improvement. Premier Inc. (at www.premierinc.com), in San Diego, is a health care alliance collectively owned by more than 200 independent hospitals and health care systems.
Fostering Change
“IDMS was created after the publication of the Institute of Medicine’s To Err Is Human report,” says Roger Resar, MD, a change agent and pulmonologist with Luther Midelfort, a health system in Eau Claire, Wis., that is a member of the Mayo Health System in Rochester, Minn., and a participant in the IDMS initiative. “A significant proportion of adverse events is related to medications. We wanted to examine our current system of medication ordering, delivery, and administration and create practical strategies for improving the safety of the system. The first question we asked ourselves was, ‘What do we want to measure?’ If you do not measure, you cannot tell if there has been improvement. For most of my 25 years in practice, the only measurement that I ever heard about was ‘error.’ But we as a group felt that we needed to have a ....

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