Patient Safety in the Hospital Pharmacy Setting: Overcoming Barriers and Identifying Solutions

Objective: The World Health Organization states that as many as 1 in 10 patients in high income countries are harmed while receiving hospital care. The purpose of this study is to understand the types of structural barriers that exist in the inpatient hospital pharmacy setting, highlight common themes, and identify solutions to overcome the barriers. Methods: A systematic review of the literature was conducted from 2001 to 2020 using PubMed with keywords such as "hospital pharmacy," "patient safety," "hierarchical structures," "organizational barriers," "information technology barriers," "environmental barriers," and "collaboration barriers". A PRISMA flow diagram was used to evaluate the process. Articles were summarized in a table organized by author(s), year published, title, study design, type of barrier, method of studying safety, findings, and solutions. The quality of articles was graded using the Oxford for Evidence-based Medicine scale. Results: One-hundred and four articles were eligible to review. The majority of studies conducted semi-structured interviews to gather pharmacist feedback on medication safety. Some common themes include lack of organizational support, environmental constraints, limited collaboration between healthcare professionals, and lack of information technology infrastructure. Proposed solutions include supporting effective multidisciplinary teams, greater involvement of pharmacists in medication reconciliation, linked prescribing databases and decision support systems, and providing advanced training and certification programs. Conclusions: Fostering organizational support and good communication between healthcare professionals will ultimately lead to improved patient safety and better health outcomes.