As the director of pharmacy for CMC, you have been experiencing an increase in drug cost of approximately eight to ten percent per year for the past three years. The annual pharmacy drug cost has increased from $10,300,000 to $16,800,000 in the past five years. The hospital is experiencing an increase in drug cost even though actual drug usage has remained stable.

Along with the increase in drug cost, drug related errors have also increased. Patient safety has become an even more serious issue. As you know, patient safety is the number one item on the national health care agenda for the next several years.

At the hospital the number of dispensing errors has increased by two percent during the past twelve months. The registered nurses who are administering the drugs have discovered many of the dispensing errors; however, the ones not discovered resulted in patients getting the wrong drug, wrong dosage, and/or the wrong frequency. When the overall drug error rate was analyzed, it was found that dispensing errors in the pharmacy were the number one cause. The overall drug error rate had increased from three percent to five percent.

Fortunately most of the dispensing errors were discovered before the medications were administered to the patients. When the incorrect drugs were administered, it resulted in adverse effects in three cases. One patient received the right medication but the wrong dosage because the medication label was incorrect. This patient had to be admitted overnight to the Intensive Care Unit for intense cardiac and respiratory monitoring. The patient stayed in ICU for approximately twenty-four hours. Another patient received the wrong medication on the day of planned discharge and had to remain in the hospital for an additional day, though only for observation. In the third case, the patient had reported that he was allergic to a certain category of drugs, but nonetheless received a drug of that type. He had an adverse reaction-a rash-which delayed his discharge by one day.

On the basis of your understanding of the above case study, express your views on the following:

1. What measures should be adopted to reduce the overall drug error rate in the hospital?

2. What special benefits should be given to the patients who have suffered due to negligence by the hospital staff for wrong drug administration and other reasons?

3. In your opinion, should the hospital staff responsible for dispensing errors be penalized for the same? Why or why not?