Magazine article Drug Topics

Testing, Testing

Magazine article Drug Topics

Testing, Testing

Article excerpt

IOM's medical error report reopens smoldering debate on relicensure examinations

Competency retesting for pharmacists is moving back to the front burner. A recently released report by the Institute of Medicine (IOM) included the recommendation that health professional licensing bodes "implement periodic re-examinations and relicensing" of key providers "based on both competence and knowledge of safety practices." Two earlier reports by the Pew Commission made similar suggestions. The National Association of Boards of Pharmacy proposed a voluntary selfassessment test of competency to address the Pew Commission concerns. After the pharmacy profession vehemently rejected the idea, NABP put it aside last year to concentrate on disease management examinations. Now, NABP plans to revisit the issue.

The IOM report estimated that as many as 98,000 Americans die annually from medical mistakes, including more than 7,000 from prescription drug errors. A private group chartered by Congress to advise the federal government, the IOM also recommended establishing a mandatory nationwide reporting system for adverse events that result in death or serious harm; creating a federal Center for Patient Safety; and increasing attention from the Food & Drug Administration on the safe use of drugs.

President Clinton said a federal interagency health-care quality task force would analyze the IOM study and report back by the end of January. "I'm also calling on the task force to evaluate the extent to which medical errors are caused by misuse of medications and medical devices, and to develop additional strategies to reduce these errors," the President said.

In response to the report, the American Hospital Association said it would partner with the Institute for Safe Medication Practices to help reduce medication errors. "We already have a good working model for reporting errors nationally, and many health-care professionals are taking advantage of it," said Michael R. Cohen, ISMP president. "But because better understanding of medication errors is at the heart of any prevention effort, more must be done to improve and increase reporting." The nonprofit ISMP reviews errors reported through the voluntary U.S. Pharmacopeia's Medication Errors Reporting Program and shares its information and analysis with the FDA's safety initiative, MedWatch.

Pharmacy organizations embraced the report's major thrust, but the retesting provision remains problematic. "Until you can demonstrate to me it's a licensing problem, I don't know that I would leap to the conclusion that it is in and of itself the solution," said Craig Fuller, president of the National Association of Chain Drug Stores, in an interview "I don't know to what extent that would address the problem. …

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