title: Sustaining and spreading the reduction of adverse drug events in a multicenter collaborative.
abstract: OBJECTIVE
  Adverse drug events (ADEs) occur more frequently in pediatric patients than adults. ADEs frequently cause serious harm to children and increase the cost of care. The purpose of this study was to decrease ADEs by targeting the entire medication-delivery system for all high-risk medications.
  
  
  METHODS
  Thirteen freestanding children's hospitals participated in this ADE collaborative. An advisory panel developed a change package of interventions that consisted of standardization of medication-ordering (eg, consensus-based protocols and order sets and high-alert medication protocols), reliable medication-dispensing processes (eg, automated dispensing cabinets and redesign of floor stock procedures), reliable medication-administration processes (eg, safe pump use and reducing interruptions), improvement of patient safety culture (eg, safety-culture changes and reduction of staff intimidation), and clinical decision support (eg, increase ADE detection and redesign care systems). ADE rates were compared from the 3-month baseline period to quarters of the 12-month intervention phase. ADE rates were categorized further as opioid related and other medication related.
  
  
  RESULTS
  From baseline to the final quarter, the collaborative resulted in a 42% decrease in total ADEs, a 51% decrease in opioid-related ADEs, and a 41% decrease in other medication ADEs.
  
  
  CONCLUSIONS
  A pediatric collaborative that targeted the medication-delivery system decreased the rate of ADEs at participating institutions.
authors: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA. tham.eric@tchden.org
authors: Eric
authors: E
authors: Tham
authors: Helen M
authors: HM
authors: Calmes
authors: Amy
authors: A
authors: Poppy
authors: Aris B
authors: AB
authors: Eliades
authors: Stacey Morgan
authors: SM
authors: Schlafly
authors: Katie C
authors: KC
authors: Namtu
authors: Dani M
authors: DM
authors: Smith
authors: Matthew C
authors: MC
authors: Vitaska
authors: Cindy
authors: C
authors: McConnell
authors: Amy L
authors: AL
authors: Potts
authors: Jenny
authors: J
authors: Jastrzembski
authors: Tina R
authors: TR
authors: Logsdon
authors: Matthew
authors: M
authors: Hall
authors: Glenn S
authors: GS
authors: Takata
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards* / Q000639:trends; D003299:Cooperative Behavior; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008510:Medication Systems, Hospital / Q000592:standards* / Q000639:trends