This research will determine how small rural hospitals (SRHs) have responded to the environmental pressure to improve patient safety and quality by implementing safe medication practices and reporting and monitoring medication errors. SRHs will be surveyed, in two random samples. For both Critical Access Hospitals (CAHs) and SRHs, the estimates of interest are the proportion that employ a full time pharmacist, the proportion that use automation in dispensing and administering medications, and the proportion that use safe medication practices.

This research will be of interest to decision makers at national, state, and local levels. At the national level, a description of the consequences of limited pharmacy support on medication use and medication error reporting in SRHs can provide the rationale for leveraging technological innovations such as telepharmacy to achieve more equitable hospital medication use systems for rural populations. At the state level, an understanding of the consequences of limited pharmacy support for medication error reporting behavior will provide a context for the importance of establishing relationships between network hospitals and CAHs (and peer groups of non-CAH SRHs with more than 25 beds). At the local level, this research can provide administrators, governing boards, and providers with a rationale to build collaborative relationships with peers, network hospitals, academic medical centers, and national error reporting systems. Aggregate error reporting systems can provide the means to monitor the outcome of patient safety in the nation's smallest hospitals as the structure and process of medication use changes through such practices as bar coding, automated dispensing machines, and telepharmacy.

Products of this research will include a policy brief describing the medication use process in SRHs with emphasis on incorporation of safe medication practices despite limited resources, and a journal submission.

Publications

• Prevalence of Evidence-Based Safe Medication Practices in Small Rural Hospitals
  RUPRI Center for Rural Health Policy Analysis
  Date: 04/2008
  This issue brief presents the findings of a national survey whose purpose was to describe the prevalence of evidence-based, safe medication practices, including the use of voluntary medication error reporting, in the nation's smallest hospitals.