Automated Surveillance for Adverse Drug Events at a Community Hospital and an Academic Medical Center

This prospective cohort study compares the rates and nature of adverse drug events (ADEs) at an academic medical center and a community hospital using a single computerized ADE surveillance system. Potential events identified by the computer were reviewed in detail by medication safety pharmacists and scored for causality and severity with findings compared between the two hospitals. Over the eight month study period, there were 1,116 ADEs in 900 patients at the university hospital for an overall rate of 4.4 ADEs per 100 admissions. At the community hospital, 399 patients experienced 501 ADEs for a rate of 6.2 events per 100 admissions. Rates of antibiotic-associated colitis, drug-induced hypoglycemia, and anticoagulation-related ADEs were significantly higher at the community hospital compared with the university hospital. Operation of a common automated ADE surveillance system across hospitals permits meaningful comparison of ADE rates in different inpatient settings. Automated surveillance detects ADEs at rates far higher than voluntary reporting, and the difference may be greater in the community hospital setting.