Rural Hospitals Have Limited Pharmacist Staffing, Technology Use, Study Finds

Minneapolis, Minn. -- Many small rural hospitals have limited hours of onsite pharmacist coverage, according to a national study that assessed how rural hospitals implement medication safety practices, focusing on pharmacist staffing and availability and use of technology.

The Upper Midwest Rural Health Research Center (UMRHRC), a partnership between the University of Minnesota and the University of North Dakota, just released a report titled, "Pharmacist Staffing and the Use of Technology in Small Rural Hospitals: Implications for Medication Safety."

According to the Institute of Medicine, an estimated 44,000 to 98,000 Americans die from medical errors every year. In addition medication-related errors for hospitalized patients cost roughly $2 billion annually.

"In hospitals with limited pharmacist coverage, pharmacists may not be able to take an active leadership role or spend significant time on medication safety activities," said report co-author Michelle Casey.

The study also found that about three quarters of hospitals use a pharmacy computer for clinical purposes, such as determining appropriate doses and screening for drug allergies or interactions. However, only three percent of hospitals are using bar code technology for bedside medication administration. A barcode system helps to ensure the right patient is receiving the right medication and dose at the right time through barcodes on the patient’s wristband and on the medications.

Cost is a major reason given by survey respondents for not implementing specific medication safety-related technologies.

"These results show the need for more funding for information technology in rural hospitals," said Ira Moscovice, who heads the UMRHRC.

"Investment in health information technology is also a key component of the Institute of Medicine Committee on the Future of Rural Health Care's strategy to address quality challenges in rural communities," Moscovice added.

The majority of hospitals have implemented key medication safety practices including a do-not-use-abbreviations list, using two patient identifiers for administering medications, having two health professionals independently check doses of high alert medications and a high alert drug list. However, only half of the hospitals have implemented all four practices.

"Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accreditation and hospital financial status are significantly related to pharmacist staffing, use of a pharmacy computer, and implementation of four key medication safety activities," said Casey. "This shows a continued need of Medicare policies to help ensure financial stability for small rural hospitals; cost-based reimbursement is a means of helping to support quality and patient safety activities."

The information for the study was collected through a telephone survey of 387 rural hospitals nationwide in the spring of 2005.

The UMRHRC was designated as one of eight rural health research centers in the nation funded by the U.S. Department of Health and Human Services Office of Rural Health Policy last year. Through the partnership, the University of Minnesota Rural Health Research Center in the School of Public Health and the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences have combined their research and information dissemination expertise to undertake national projects focusing on quality of rural health care.

A copy of the report is available at: http://www.uppermidwestrhrc.org/pdf/medication_safety.pdf

Contact: Wendy Opsahl, University of North Dakota Center for Rural Health, 701-777-0871, wopsahl@medicine.nodak.edu

Michelle Casey, University of Minnesota Rural Health Research Center, 612-626-6252, mcasey@umn.edu

1-4-06