The role of management systems in medication safety

Medication errors cause over 7000 deaths and cost up to 29 billion dollars per year. The Institute of Medicine (IOM) has established that major systems failures are to blame for these deaths. Unfortunately, health care professionals are often poorly trained in systems thinking; as a result efforts to substantially improved system performance have not met with very good results. A joint effort between Management and Industrial Systems engineers and health care practioners is working to study and improve processes designed to reduce medication errors in a large VA hospital.