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International Journal of Family Medicine
Volume 2012 (2012), Article ID 374639, 6 pages
Research Article

Effects of Self-Empowered Teams on Rates of Adverse Drug Events in Primary Care

1Department of Family Medicine, State University of New York at Buffalo, Buffalo, NY 14203, USA
2UB Patient Safety Research Center, State University of New York at Buffalo, Buffalo, NY 14203, USA
3School of Management, State University of New York at Buffalo, Buffalo, NY 14215, USA

Received 3 August 2011; Revised 3 November 2011; Accepted 6 December 2011

Academic Editor: Benjamin Miller

Copyright © 2012 Ranjit Singh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Most safety issues in primary care arise from adverse drug events. Team Resource Management intervention was developed to identify systemic safety issues to design and implement interventions to address prioritized issues. Objectives. Evaluate impact of intervention on rates of events and preventable events in a vulnerable population. Design. Cluster randomized trial. 12 practices randomly assigned to either: (1) Intervention; (2) Intervention with Practice Enhancement Assistants; (3) No intervention. The intervention took 12 months. Main Outcome Measure. Rate and severity of events and preventable events measured using a Trigger Tool chart review method for the 12-month periods before and after the start of the intervention. Results. In the ‘‘intervention with Assistants’’ group there was a statistically significant decrease in the overall rate of events and in the rate of moderate/severe events. Analysis of Variance with study arm and time as the factors and moderate/severe events as the outcome showed a significant interaction between arm and time supporting the notion that the ‘‘Intervention with Assistants’’ practices had a greater reduction in moderate/severe preventable events. Conclusions. The intervention had a significant effect on medication safety as estimated using a trigger tool. Further exploration of role of Assistants and trigger tool is warranted.