title: Impact of a Swiss adverse drug event prevention collaborative.
abstract: OBJECTIVE
  The Hospital Federation of Vaud (Switzerland) used a Breakthrough Collaborative with the aim of reducing adverse drug events (ADEs) by 20% in 10 participating hospitals.
  
  
  METHODS
  A set of interventions (covering patient identification, high-alert medication and medication preparation in the ward) was deployed over 18 months starting in October 2010. All hospitals monitored discrepancies between drugs prescribed and those prepared for administration, as well as the occurrence of ADEs using the ADE Trigger Tool for 18 months (cohort 1). A subset of five hospitals continued this monitoring for 12 additional months (cohort 2).
  
  
  RESULTS
  In cohort 1, pill box discrepancies were present in 5.9% of doses (n = 9772) in 2011 and in 5.8% (n = 2251) in the first 3 months of 2012 (no statistical significance). There were no significant differences in the rate of ADEs/1000 doses across time (1.2 in 2010, 1.0 in 2011 and 1.0 in 2012). In cohort 2, pill box discrepancies were reduced from 6.5% (n = 4846 doses) in 2011 to 4.4% (n = 7355) in 2012 (P < 0.001) to 3.0% for the first 3 months of 2013 (n = 2251; P = 0.004). The rate of ADEs/1000 doses decreased (1.8 in 2010, 1.1 in 2011 and 0.6 in 2012/13 (P = 0.008 for 2010-2011, and P < 0.001 for 2011-2012/2013).
  
  
  CONCLUSIONS
  Reductions in drug discrepancies and ADEs occurred in the cohort with the longer monitoring duration. Factors contributing to success may include the strategic status of the project, executive support, perseverance in post-intervention measurement, and institution-wide rather than partial deployment.
authors.affiliation: Patient Safety Programme, Hospital Federation of Vaud, Prilly, Switzerland.|IFROSS Institute, University of Lyon 3, Lyon, France.
authors.forename: Anthony
authors.initials: A
authors.lastname: Staines
authors.affiliation: Hospital Federation of Vaud, Prilly, Switzerland.
authors.forename: Costanza
authors.initials: C
authors.lastname: Mattia
authors.affiliation: School of Medicine, Geneva University, Geneva, Switzerland.|La Côte Inter-Hospital Pharmacy, Morges, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Schaad
authors.affiliation: Stat'Elite, Nyon, Switzerland.
authors.forename: Estelle
authors.initials: E
authors.lastname: Lécureux
authors.affiliation: School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.|Pharmacy, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bonnabry
mesh_terms: D003299:Cooperative Behavior; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D006302:Health Services Research; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital; D010043:Outcome and Process Assessment, Health Care; D013557:Switzerland
keywords: Breakthrough Collaborative; Trigger Tool; adverse drug events; medication safety; quality improvement