Hospital Rules-Based System
Hospital Rules-Based System
Purpose: The hospital rules-based system (HRBS) and its subsystems at a major medical center are described.
Summary: The HRBS was implemented at the Mayo Clinic to rapidly identify and communicate crucial information to the clinician in order to optimize patient care. The system also enhances workload efficiency and improves documentation and communication. The system is used by the infectious-diseases division, pharmacy services, nutritional support services, infection control, and the nursing department. The six HRBS subsystems are Web-based programs that share a common structural design and integrate computerized information from multiple institutional databases. The integrated data are presented in a user-friendly format that improves the efficiency of data retrieval. Information, such as monitoring notes and intervention information, can be entered for specific patients. The subsystems use rules designed to detect suboptimal therapy or monitoring and identify opportunities for cost savings in a timely manner.
Conclusion: The HRBS enhances the identification of drug-related problems while optimizing patient care and improving communication and efficiency at a major medical center.
Of the more than 700,000 adverse drug events estimated to occur each year in U.S. hospitals, nearly 28% are attributed to a preventable medication error, with most occurring during drug ordering. Others occur at the time of pharmacist processing, drug administration, and monitoring. Deaths from medication errors are estimated to total some 7000 per year. Although physicians, pharmacists, and nurses are diligent about preventing adverse drug events and medication errors, preventable events still occur, often because of inadequate availability of information or institutional information-system failures. Prevention strategies targeting systems rather than individuals are generally most effective in reducing errors.
Computerized information systems are gaining increasing recognition as a tool for reducing medication errors. Strategies used by these systems include improved communication with clinicians, more accessible medical knowledge, better monitoring techniques, automated calculations, and support for clinical decisions.
The Mayo Clinic developed its first rules-based informatics program during the late 1980s to reduce medication errors and improve education of and communication with clinicians. The system predominantly monitored antimicrobial prescribing practices and resulted in improvements in hospital patient care and drug cost savings. The success of this program led to the expansion of a common technological architecture called the hospital rules-based system (HRBS), composed of several subsystems. The rules-based subsystems were developed for more comprehensive, multidisciplinary patient monitoring and cost containment. This article describes the HRBS and each of its subsystems.
Purpose: The hospital rules-based system (HRBS) and its subsystems at a major medical center are described.
Summary: The HRBS was implemented at the Mayo Clinic to rapidly identify and communicate crucial information to the clinician in order to optimize patient care. The system also enhances workload efficiency and improves documentation and communication. The system is used by the infectious-diseases division, pharmacy services, nutritional support services, infection control, and the nursing department. The six HRBS subsystems are Web-based programs that share a common structural design and integrate computerized information from multiple institutional databases. The integrated data are presented in a user-friendly format that improves the efficiency of data retrieval. Information, such as monitoring notes and intervention information, can be entered for specific patients. The subsystems use rules designed to detect suboptimal therapy or monitoring and identify opportunities for cost savings in a timely manner.
Conclusion: The HRBS enhances the identification of drug-related problems while optimizing patient care and improving communication and efficiency at a major medical center.
Of the more than 700,000 adverse drug events estimated to occur each year in U.S. hospitals, nearly 28% are attributed to a preventable medication error, with most occurring during drug ordering. Others occur at the time of pharmacist processing, drug administration, and monitoring. Deaths from medication errors are estimated to total some 7000 per year. Although physicians, pharmacists, and nurses are diligent about preventing adverse drug events and medication errors, preventable events still occur, often because of inadequate availability of information or institutional information-system failures. Prevention strategies targeting systems rather than individuals are generally most effective in reducing errors.
Computerized information systems are gaining increasing recognition as a tool for reducing medication errors. Strategies used by these systems include improved communication with clinicians, more accessible medical knowledge, better monitoring techniques, automated calculations, and support for clinical decisions.
The Mayo Clinic developed its first rules-based informatics program during the late 1980s to reduce medication errors and improve education of and communication with clinicians. The system predominantly monitored antimicrobial prescribing practices and resulted in improvements in hospital patient care and drug cost savings. The success of this program led to the expansion of a common technological architecture called the hospital rules-based system (HRBS), composed of several subsystems. The rules-based subsystems were developed for more comprehensive, multidisciplinary patient monitoring and cost containment. This article describes the HRBS and each of its subsystems.
