Prospective Study of the Multisite Spread of a Medication Safety Intervention: Factors Common to Hospitals With Improved Outcomes.

Document Type

Article

Publication Date

1-2024

Identifier

DOI: 10.1097/JMQ.0000000000000161

Abstract

Context and implementation approaches can impede the spread of patient safety interventions. The objective of this article is to characterize factors associated with improved outcomes among 9 hospitals implementing a medication safety intervention. Nephrotoxic Injury Negated by Just-in-Time Action (NINJA) is a pharmacist-driven intervention that led to a sustained reduction in nephrotoxic medication-associated acute kidney injury (NTMx-AKI) at 1 hospital. Using qualitative comparative analysis, the team prospectively assessed the association between context and implementation factors and NTMx-AKI reduction during NINJA spread to 9 hospitals. Five hospitals reduced NTMx-AKI. These 5 had either (1) a pharmacist champion and >2 pharmacists working on NINJA (Scon 1.0, Scov 0.8) or (2) a nephrologist-implementing NINJA with minimal competing organizational priorities (Scon 1.0, Scov 0.2). Interviews identified ways NINJA team leaders obtained pharmacist support or successfully implemented without that support. In conclusion, these findings have implications for future spread of NINJA and suggest an approach to study spread of safety interventions more broadly.

Journal Title

American journal of medical quality : the official journal of the American College of Medical Quality

Volume

39

Issue

1

First Page

21

Last Page

32

MeSH Keywords

Humans; Prospective Studies; Acute Kidney Injury; Drug-Related Side Effects and Adverse Reactions; Hospitals; Pharmacists

Keywords

Prospective Studies; Acute Kidney Injury; Drug-Related Side Effects and Adverse Reactions; Hospitals; Pharmacists

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