Abstract:
Purpose: This quality improvement initiative aimed to assess the impact of smart infusion pump-electronic medical record (EMR) interoperability on patient safety events, user programming compliance, and hospital staff productivity at a large academic health system.
Methods: Retrospective, deidentified Spectrum IQ smart infusion pump data (collected from January 2021 to August 2024) from 6 University of Texas Medical Branch hospitals that included integrated drug groups spanning the period before and after EMR integration in quarter 4 of 2022 were analyzed. Infusions for medications in the critical care and acute care area drug groups were included if they had a positive dose. Infusions were excluded if they were associated with multiple care areas or had a duration of more than 24 hours. Data were collected on safety events (hard and soft limit alerts, single-step rate change [SSRC] alerts, good catches, pullbacks, overrides), productivity metrics (number of programming steps, median time to initiate infusions, mean time to resolve alerts), and compliance with programming approaches. Outcomes were analyzed descriptively and compared across various subgroups using (2 tests, t tests, or Wilcoxon rank-sum tests.
Results: Smart pump-EMR integration significantly reduced the occurrence of medication safety alerts: the rate of hard limit, soft limit, and SSRC alerts decreased by 50.3%, 30.4%, and 38.1%, respectively (all P < 0.001). These reductions were consistent across high-alert medications (HAMs)/Risk Evaluation and Mitigation Strategies (REMS) medications and the top 20 medications by alert frequency. The rate of good catches also decreased after integration. Autoprogramming had fewer programming steps (1.6 vs 3.3 steps) and shorter alert resolution times (46.3% shorter for soft limit alerts and 55.0% shorter for SSRC alerts) than manual programming (both P < 0.001). Dose error reduction system compliance increased to 96.1% after integration, while autoprogramming compliance was 53.4% overall and 68.3% for HAMs/REMS medications.
Conclusion: Smart pump-EMR integration and autoprogramming were associated with significantly fewer safety alerts, fewer steps to initiate infusions, and shorter times to resolve alerts. These benefits underscore the importance of effective integration and ongoing optimization of drug libraries and staff training for enhanced patient safety and workflow.
Reference:Afaq H, Colunga S, Hu L, Zhang X, Munson S, Norton J, Townley P, Meyer J, Carpenter L, Hoh T, Perampaladas K, Schuler B, Silberhorn R, Alam A. Integration of smart infusion pumps with electronic medical records improves safety and staff productivity at a large academic healthcare system. Am J Health Syst Pharm. 2026 Jun 27:zxag187. doi: 10.1093/ajhp/zxag187. Epub ahead of print. PMID: 42364102.
