Innovative approach to the medication verification process: Role of pharmacists in the minimization of confirmation bias

Abstract

Purpose: Medication errors may stem from confirmation bias, a type of selective thinking to support one’s own preconception rather than what is actually true. Our objective was to describe an innovative approach to the medication verification process that minimizes confirmation bias.

Summary: In September 2014, our pharmacy team implemented a unique double-check method that limited confirmation bias within the medication verification process for the compounding of non-sterile oral products and sterile intravenous admixtures. Our innovative approach required the pharmacist to first check the constituents and the final product without directly viewing the label, and then double check against the final product label. A confirmation bias form was used to ensure adherence to the newly designed workflow. The primary factor contributing to confirmation bias was expectation. Over the 29-month study period, we observed an immediate reduction in escaped defects (30 pre- to 0-4 post-implementation). Most of the escaped defects were “potential” medications errors that were captured prior to leaving the pharmacy and did not reach the patient nor resulted in any harm. While this process improved medication safety, there was no change in pharmacy staff requirement, indicating its cost neutrality.

Conclusion: The elimination of confirmation bias and incorporation of a double-check system during the drug verification process improved the safe use of medications without additional staffing cost.