Leveraging information technology to promote the safe and effective use of vaccines

PURPOSE: The Institute for Safe Medication Practices (ISMP) collected data about vaccine-related errors, resulting in a new targeted medication safety best practice for vaccine error prevention strategies. ISMP best practice 22 includes 10 interventions that should be implemented to safeguard against vaccine-related errors in the inpatient and outpatient settings. The goal of this publication is to outline operational and electronic health record (EHR)-based interventions that have been successfully implemented to mitigate vaccine errors. SUMMARY: The goal of the Cleveland Clinic Health System vaccine governance committee is to maintain a vaccine formulary that maximizes adherence to published adult and childhood immunization schedules while minimizing the risk of error. EHR-based interventions to address ISMP best practice 22 were implemented and include standardization of vaccine nomenclature and EHR alerts prior to vaccine administration to prevent errors related to wrong interval, wrong dose, or wrong age. Additionally, ordering decision support was implemented to display vaccine orders to providers through groupings of orders. Administration-specific questions were also added to improve vaccination practices and reduce the risk of error at the time of vaccine administration. CONCLUSION: Overall, a variety of EHR-based mechanisms have been used to ensure the safety and effectiveness of the vaccine-use process. Guidance from external governing bodies, namely ISMP, has been evaluated in relation to current tools and practices and promoted using EHR tools. While there are gaps that have been identified, the effort to ensure patient safety for vaccinations and adherence to guidance is clear.