How often do physicians review medication charts on ward rounds?

An observer noted how often consultant physicians at Auckland City Hospital reviewed medication charts during ward rounds. The physicians were not aware that they were being observed.Twenty-one physicians were observed over a 26 week period. The general physicians reviewed the medication charts on 77% of occasions (range: 45% – 100%) during routine ward rounds and 65% of the time (range: 41% – 80%) on post admission rounds. Subspecialty physicians who did not see more than 8 patients on their rounds reviewed medication charts more frequently (88%) than those specialties where more than 8 patients were seen on average (61%).The physicians did not review medication charts on all ward rounds and there was considerable variation in how often they did this. There is some evidence that the frequency with which charts are reviewed decreases as the number of patients seen increases. More efforts should be made to encourage regular review of medication charts.Prescribing errors are common in the hospital. In different studies adverse drug events have been reported to occur in 0.7% to 6.5% of hospital admissions [1]. 28% to 56% of these adverse drug events were thought to be preventable [2]. Bates et al estimated that each preventable adverse event leads to an additional cost of US $4,685 and increase in the length of stay of 4.6 days [3]. A number of interventions have been proposed to reduce medication errors including regular review of medication charts by doctors on ward rounds [2]. A case can be made for consultant staff to review all of the medication charts on every ward round that they go on. There is evidence that consultants make fewer prescribing errors than their junior medical staff [4,5] and they are well placed to detect errors made by the junior medical staff. If they review medication charts on each ward round it also emphasizes the importance of doing this to the junior medical staff. However we are not aware of any previous studies that document how often c