According to estimates by the FOPH, 1,200 to 1,800 people die each year in Switzerland due to medication prescribing errors, and 200 of these deaths could be prevented. The problem also arises in hospitals, where one in ten patients is affected by such an error.
Patient discharge: a critical moment
It is estimated that 20,000 hospital stays per year are due to medication-related issues. These thus represent the second leading cause of adverse events in hospitals, just behind medical procedures. These errors can occur throughout the entire medical care chain in both outpatient and inpatient settings, but it is recognized that periods of care transition expose patients to an increased risk. Patient discharge following a hospital stay is a critical moment for prescribing errors. These errors are responsible for a large number of readmissions and/or emergency department visits in the days following discharge. Therefore, we focused on patient discharge from the internal medicine department at L’Hôpital de La Tour, where more than 1,300 patients are hospitalized annually.
Polypharmacy or a Predisposition to Prescribing Errors
It is estimated that, on average, more than 6 medications are administered per day per patient: this polypharmacy obviously increases the risk of prescribing errors. The internal medicine units (UMI/UMC) at L’Hôpital de La Tour have implemented a quality improvement project focused on medication reconciliation. This initiative addresses both patient admission—where healthcare providers cross-check multiple sources to verify the patient’s treatment and prevent errors—and patient discharge, where several measures are taken to ensure follow-up and adherence. A clinical pharmacist participates in medical rounds once a week and provides expert advice to reduce unnecessary polypharmacy while checking for drug interactions. Upon discharge from the hospital, a pharmacy assistant verifies once again that the patient has fully understood their treatment and, if necessary, prepares a treatment card. The goal is to reduce avoidable rehospitalizations resulting from prescribing errors, as reported by the National Association for Quality Development in Hospitals and Clinics (ANQ).
Prof. Dr. med. Omar Kherad, MPH, Chief of Internal Medicine, Quality Manager