Frequency, Timing, and Types of Medication Ordering Errors Made by Residents in the Electronic Medical Records Era

Ari Garber, Amy S. Nowacki, Alexander Chaitoff, Andrei Brateanu, Colleen Y. Colbert, Seth R. Bauer, Zubin Arora, Ali Mehdi, Simon Lam, Abby Spencer, Michael B. Rothberg

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Objectives To describe associations between resident level of training, timing of medication orders, and the types of inpatient medication ordering errors made by internal medicine residents. Methods This study reviewed all inpatient medication orders placed by internal medicine residents at a tertiary care academic medical center from July 2011 to June 2015. Medication order errors were measured by pharmacists' reporting of an error via the electronic medical record during real-time surveillance of orders. Multivariable regression models were constructed to assess associations between resident training level (postgraduate year [PGY]), medication order timing (time of day and month of year), and rates of medication ordering errors. Results Of 1,772,462 medication orders placed by 335 residents, 68,545 (3.9%) triggered a pharmacist intervention in the electronic medical record. Overall and for each PGY level, renal dose monitoring/adjustment was the most common order error (40%). Ordering errors were less frequent during the night and transition periods versus daytime (adjusted odds ratio [aOR] 0.93, 95% confidence interval [CI] 0.91-0.96, and aOR 0.93, 95% CI 0.90-0.95, respectively). Errors were more common in July and August compared with other months (aOR 1.05, 95% CI 1.01-1.09). Compared with PGY2 residents, both PGY1 (aOR 1.06, 95% CI 1.03-1.10), and PGY3 residents (aOR 1.07, 95% CI, 1.03-1.10) were more likely to make medication ordering errors. Throughout the course of the academic year, the odds of a medication ordering error decreased by 16% (aOR 0.84, 95% CI 0.80-0.89). Conclusions Despite electronic medical records, medication ordering errors by trainees remain common. Additional supervision and resident education regarding medication orders may be necessary.

Original languageEnglish
Pages (from-to)25-31
Number of pages7
JournalSouthern medical journal
Issue number1
StatePublished - Jan 1 2019


  • electronic medical record
  • house staff
  • medication errors
  • residents


Dive into the research topics of 'Frequency, Timing, and Types of Medication Ordering Errors Made by Residents in the Electronic Medical Records Era'. Together they form a unique fingerprint.

Cite this