Using Six Sigma to reduce medication errors in a home-delivery pharmacy service.
BACKGROUND
Medco Health Solutions, Inc. conducted a project to reduce medication errors in its home-delivery service, which is composed of eight prescription-processing pharmacies, three dispensing pharmacies, and six call-center pharmacies.
Medco uses the Six Sigma methodology to reduce process variation, establish procedures to monitor the effectiveness of medication safety programs, and determine when these efforts do not achieve performance goals. A team reviewed the processes in home-delivery pharmacy and suggested strategies to improve the data-collection and medication-dispensing practices. A variety of improvement activities were implemented, including a procedure for developing, reviewing, and enhancing sound-alike/look-alike (SALA) alerts and system enhancements to improve processing consistency across the pharmacies.


RESULTS
"External nonconformances" were reduced for several categories of medication errors, including wrong-drug selection (33%), wrong directions (49%), and SALA errors (69%). Control charts demonstrated evidence of sustained process improvement and actual reduction in specific medication error elements.


CONCLUSIONS
Establishing a continuous quality improvement process to ensure that medication errors are minimized is critical to any health care organization providing medication services.
Medco Health Solutions, Franklin Lakes, New Jersey, USA.
Lon
L
Castle
Ellen
E
Franzblau-Isaac
Jim
J
Paulsen
D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D019982:Organizational Case Studies; D009937:Organizational Objectives; D010593:Pharmaceutical Services / Q000458:organization & administration*; D011177:Postal Service; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D017749:Total Quality Management / Q000379:methods / Q000458:organization & administration*