March 21, 2008
Making medications safer with EMAPPS

With medication errors a growing concern for health care organizations across the country, the MGH is putting into place a new system for ordering and administering medications to patients. Commonly referred to in the health care industry as a "closed loop system," the MGH's new online system is known as the electronic medication administration record (eMAR), while the entire initiative is called the Electronic Medication Administration Process for Patient Safety (EMAPPS). The overall EMAPPS system aims to enhance patient safety by decreasing the number of medication-related adverse events at the hospital.

EMAPPS encompasses three distinct components: the implementation of Provider Order Entry (POE) and Chemotherapy Order Entry (COE), computerized patient information systems that have been used at the MGH since 1998; the development of an interface between POE/COE and Sunquest, the MGH Pharmacy's current online medication ordering system; and the rollout of eMAR beginning in March 2009, which will include the bar coding of medications and patient wristbands and automated documentation of medication administration. Currently, the EMAPPS team is nearing the completion of a major project milestone — the POE and COE integration with Sunquest — which will greatly improve patient safety by eliminating the hand entering of medication orders into the Pharmacy system when it goes live in June 2008. This halfway mark was celebrated at a special luncheon in January by the committee, which is co-chaired by Jeanette Ives Erickson, RN, MS, FAAN, senior vice president for Patient Care and chief nurse; and Jackie Somerville, RN, PhDc, associate chief nurse.

"When you think about a safe, highly reliable environment for patient care, medication safety immediately comes to mind," says Ives Erickson. "For far too long we have relied upon memory as the safety net for our medication distribution and administration system. This is not enough. Nurses, physicians and pharmacists can't shoulder full responsibility for drug safety. That's why we are advocating a total systems view to prevent medication errors, and this is very exciting. I am fortunate to work with a very passionate all-star team on this important issue."

More information about EMAPPS will be available in future issues of MGH Hotline and through other hospitalwide communications. For questions, contact Rosemary O'Malley, RN, at (617) 726-9663 or

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