Focus your efforts
Determine where your challenges exist by evaluating current use of error-prone abbreviations.
Demonstrate the need for an abbreviation initiative. Find a champion on the executive team. Continue to keep leadership informed of the project’s progress.
Consider targeting only one abbreviation or one high risk medication to start with. It could be an abbreviation that has caused a significant patient adverse event in your practice site or one that is used frequently; it could be a high risk medication, such as insulin, where use of abbreviations has been a factor in close calls or errors.
Include representation from all healthcare provider groups who will be affected: those who write orders or document in the health record, those who review or transcribe orders, and those who dispense or administer medications. From each group recruit early adopters to test the changes and find champions to help promote the project. Listen to ideas from the frontline.
Work towards an information technology solution
Computerization is a key strategy to reduce the use of abbreviations. Consider a stand-alone order entry or prescription writing program if a comprehensive electronic health record is not financially feasible.
Develop system supports for the change – structure, process and tools
Develop a medication order writing policy or documentation guideline to address the use of error-prone abbreviations. Update your medication order forms with a section listing unapproved abbreviations and the preferred options.
Inform prescribers and other staff at the start of the initiative and continue with monthly updates at committee or staff meetings. Use bulletin boards in staff areas to keep staff updated about progress with the initiative.
Make education a priority
Be creative and use several approaches to increase awareness. Include an educator on the team to assist with planning. On-going education is essential.
Partner with others
Remember to include those who provide contracted services (e.g., doctors and pharmacists) in the initiative. Consider forming a collaborative with other facilities, clinics, and pharmacies in your community.
Be patient and persistent
Changing ‘old habits’ takes time and effort.
Take time to celebrate
Share ongoing evidence and reward positive actions and results.