Hospitals are where doctors bring babies safely into the world, but they are also dangerous places where patients are vulnerable to hospital-acquired infections and a host of harmful medical errors.
A recent analysis which graded more than 2,500 U.S. hospitals on safety gave more than 1,000 of them a C or worse.
One way to ensure safe care in hospitals is to reduce the number of medications patients are on when they are in the hospital.
The proposal is simple: stop all home medications at the time of admission, unless there is a compelling medical reason to continue them during the hospitalization. At discharge patients should not resume any home medicine unless there is a compelling reason to do so.
The Institute of Medicine estimates that the rate of medication errors in hospitals is one error per patient per day. Part of what makes hospital care dangerous is complexity. In the U.S. generally patients are on nine or ten medications when they are admitted to the hospitals.
The more medications a patient is prescribed, the more difficult it is to care for them safely and effectively. The risk of being harmed by a medicine increases as the number of medicines one is on increases since the risk of drug-drug interactions and drug-disease interactions increases. Each new medicine creates multiple opportunities for wrong drug errors, wrong dose errors etc…
Each new step will decrease the chance that the overall process will be carried out successfully because not hospital has a perfect process. Therefore, the logical answer is to simplify a patient’s drug therapy regimen and make care safer.
Stopping all home medications during hospitalizations will also increase the efficiency of hospital care. Currently, U.S. hospitals spent about $30 billion on drugs in 2014, therefore, even a 1% reduction in expenditures would produce $300 million in savings.
Savings would come from avoiding the cost of drug product itself, saving labor costs associated with order, transcribing, dispensing, administering and monitoring the drug in addition to avoiding the human and financial costs associated other medication-related harm.
It may sound reckless to stop a patient’s medication, however in reality, many medications are unnecessary or inappropriate. Many only have marginal benefits and many of these benefits are more or less unaffected by stopping them for a few days.