Hospital To Home
Reducing Your Risk of Medication Errors During Transitions of Care
Recent studies indicate that approximately 20% of patients discharged to home from a hospital will experience an adverse event during this transition and that over two-thirds of these events are drug-related. In fact, any move of a person from one setting of care to another can introduce the risk that a needed medicine might be forgotten or overlooked, or that the order for the medicine might accidentally be written with the wrong dose. The person's medical records sometimes might not be readily available.
Another problem when people leave the hospital is that the doctor who provided care in the hospital may be a different doctor than the one who will provide care after the hospital discharge. These doctors may sometimes have difficulty sharing information with each other to make sure that the person's medical care and medicines continue to be managed consistently.
For a variety of reasons, medication errors can occur during these care transitions. Since older adults frequently take more medicines than younger persons, their risk for problems may be higher.
Reducing Your Risk
The most important principle in preventing errors during moves from one care setting to another is that the patient must play an active role in coordinating care. Having a family member or friend to help is a good idea.
There are ways to reduce the risk of medicine problems during a move to or from the hospital, nursing home, assisted living, or other care setting. The most important step is to keep an updated record of all the medicines you take, including any over-the-counter medicines, herbal products, and dietary supplements. You can use this Personal Medication List form to keep track of your medicines. Remember to update the form, or ask your doctor or pharmacist to help you update it, each time your medicines are changed.
Keep your medication list in your purse or wallet so that it can be used in case of an emergency. The list won't do you any good if you don't have it with you when you need it.
Older adults should have one doctor that serves as the primary care or general physician. Although older adults may see a number of specialists for various problems, it is helpful to have one physician that oversees all the care provided and helps to coordinate with the specialists.
Many hospitals today employ hospitalists. These are physicians who provide care to persons during their hospital stay, but are generally not involved in the care of persons before or after their hospital stay. For this reason, it is especially important that persons who are discharged from the hospital make sure that their primary care physician receives a report from their hospital stay.
When you go to the hospital:
- Take your medication list with you so that the doctors and nurses will know what you are taking.
- Make sure you tell the hospital staff about any allergies you have to medicines or other substances, such as foods. It does not hurt to remind the nurse about your allergies before you are given medicines.
- Do not let anyone give you medicines without checking your hospital ID bracelet every time. This helps prevent you from getting someone else's medicines.
- Look at the medicines before you take them and ask questions if you have any, especially if the medicine looks unfamiliar.
- If possible, arrange for a family member or friend to be with you as much as possible when you are in the hospital. Ask this person to help you check to make sure that you receive the correct medicines.
- When you are ready to go home, have the doctor, nurse, or pharmacist go over each medicine with you and a family member. Update your medicine list from home if any medicines have been added, changed, or discontinued.
This brochure, “Taking Care of My Health Care” from the National Transitions of Care Coalition (NTOCC), may be helpful to you and your family members in helping to manage your health care.
Who Can Help?
Some health professionals have been especially trained to help older adults and can be especially useful during transitions of care, such as discharge from the hospital.
A geriatric care manager is often a social worker or nurse who has special training in assisting older adults and family members with the special needs of the older adult. To learn more about geriatric care managers, or to find a geriatric care manager in your area, check the Web site of the National Association of Professional Geriatric Care Managers.
Because medicines are such an important part of the care provided to most older adults, a senior care pharmacist can be especially helpful. These pharmacists have training and experience in working with older adults and their doctors to help ensure that medicines are being used in the best way to achieve the desired goals. For more information about senior care pharmacists, or to find a senior care pharmacist in your area, go to the ASCP web site.
Some senior care pharmacists have passed an examination to become a Certified Geriatric Pharmacist (CGP). For more information, check the Web site of the Commission for Certification in Geriatric Pharmacy: http://www.ccgp.org.
A physician who specializes in care of older adults is called a geriatrician. The United States has only about 7,000 geriatricians and over 35 million older adults. So, most older adults have a primary care physician who does not have specialized training in geriatrics.A gerontological nurse practitioner is a nurse with advanced training in the care of older adults. These persons often serve as primary care providers in conjunction with physicians and can prescribe medicines in most states. More information is available from the Gerontological Advanced Practice Nurses Association: https://www.gapna.org.
Listed below are links to other resources and information to help keep you safe during transitions from one setting of care to another.
- The National Transitions of Care Coalition is a coalition of 29 national organizations that is working to reduce medical errors that may occur when people move from one setting of care to another.
- The Institute for Safe Medication Practices has a Consumer Web Page with a variety of links and useful resources to help consumers use medicine safely.
- The Agency for Healthcare Research and Quality has this resource page with links and information: Consumers & Patients.
- The SOS-Rx Coalition is composed of more than 70 organizations and is focused on enhancing the safety of medication use by consumers, especially older adults. The coalition is developing resources to help advance this mission.
Go to the Links page for additional resources.