Medication Use Safety Rotation

Preceptor: Joanne Kowiatek

The intent of the Medication Use Safety rotation is to providean educational and administrative experience comprised of involvement in the processes related to review, reporting, investigation, analysis and trending of medication event/errors and development or recommendation of actions for error prevention. This may involve use of root cause analysis (RCA) failure mode and effect analysis (FMEA), and/or other continuous quality improvement tools. The pharmacy resident will be involved in developing educational interventions and process changes and may assist with their implementation to prevent medication errors.  The rotation involves interaction with multiple health care disciplines, from administrative to staff level, and with various hospital departments. This rotation also includes involvement and education related to pharmacy and hospital regulatory compliance activities (eg.  JCAHO, Department of Health..), policy and procedure preparation and development, ensuring appropriate medication safety, security and control in all patient care areas where medications are stored and review and involvement with the pharmacy emergency medication  exchange processes. This rotation provides the opportunity for the resident to be actively involved in the UPMC Presbyterian medication safety program as well as introduction to the UPMC health system goals for medication use safety and patient safety, related to medication error prevention.  The resident will be exposed to in-depth review of medication errors, determination of root cause, appropriate corrective actions, how to measure effectiveness of those actions.  

The objectives of the rotation are as follows:

1. Understand the requirements of legal, regulatory, and accrediting agencies affecting pharmacy operations.
2. Understand the UPMC PUH/MUH pharmacy emergency medication exchange processes.
3. Develop plans for quality management.
4. Explain the UPMC PUH/MUH medication event reporting process.
5. Understand the UPMC classification of medication errors and patient severity outcome, how medication errors occur, and how systems and process failures are involved in leading to the event occurrence. 
6. Define the role of the medication patient safety manager in promoting safe medication use.
7. Develop and provide educational programs related to medication safety and error prevention for healthcare professionals.