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The PSNet Collection: All Content

The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.

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Gardella JE, Cardwell TB, Nnadi M. Jt Comm J Qual Patient Saf. 2012;38:452-458.
In this study, preadmission medication reconciliation accuracy was dramatically improved from a baseline of 16% up to 89% by the use of pharmacy technicians in the emergency department (ED). This likely was the major contributor to the reduction of observed inpatient medication errors from 13.2% down to 1.5% postintervention. The authors also describe a separate pharmacist-driven postdischarge educational effort for complex patients. Implementation of the Safe Med program significantly decreased 30- and 60-day readmissions and ED visits. These findings contribute to prior literature that suggest pharmacist-led interventions have the most promise for improving medication reconciliation and decreasing adverse drug events (although at least one study failed to show benefit). An AHRQ WebM&M commentary discusses a case of medication error leading to a preventable readmission.