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Spotlight on Curiosity:

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Molly S. and the Evolution of "High Risk" to "High Alert" Medications


This week, we're shining a spotlight on Molly S., a student currently taking the Pharmacy Technician Career and Technical Education (CTE) course at her local high school! I always encourage students to ask questions and seek clarification, and Molly did just that. During a recent lesson, we discussed medications that can cause significant harm to a patient if an error is made. Among the possible responses were "high-alert" and "high-risk." When Molly selected "high-risk" and did not receive credit for it, she asked, "Isn't it the same thing?"



Her question sparked a great class discussion and opened the door to an important conversation about the evolution of medical terminology and its impact on patient safety—a topic that is crucial for all healthcare professionals. Let's delve into the history and reasons behind this change in terminology, which has played a key role in promoting patient safety practices.

A Look Back: Before the 1990's

Before the 1990s, "high-risk" medications were a loosely defined category of drugs known for their higher likelihood of causing harm if not administered correctly. These medications often required more meticulous attention, yet there was no standardized approach to identify or manage them systematically. Healthcare professionals were aware of the potential dangers, but the language used at the time didn't necessarily reflect the need for a structured safety strategy.


The Shift Begins: Late 1990's

Molly's curiosity led us to discuss a pivotal shift that began in the late 1990s. During this time, patient safety organizations, including the Institute for Safe Medication Practices (ISMP), started advocating for healthcare systems to adopt more vigilant safety measures for certain medications. The ISMP introduced the term "high-alert medications" to underline the importance of heightened awareness and attention when dealing with these drugs. This new terminology emphasized the need for alertness rather than simply identifying the drugs as high-risk. 



The rationale behind this shift was to foster a culture of safety. Using the term "high-alert" communicated that these medications required proactive measures, specific protocols, and greater caution to avoid errors. The focus moved from the potential danger (high-risk) to a mindset of increased vigilance (high-alert), a subtle but powerful change in how healthcare professionals approached medication safety.




Early 2000's: Standardizing Safety Practices

By the early 2000s, "high-alert medications" had become a widely accepted term across the healthcare industry. Healthcare organizations began adopting standardized practices aimed at reducing medication errors. This included clear labeling, specialized storage requirements, and targeted staff training to ensure safe handling and administration of these medications. 


The Joint Commission, a leading accreditor of healthcare organizations in the United States, supported the move by incorporating "high-alert" terminology into its National Patient Safety Goals. This endorsement helped cement the change in practice and emphasized the ongoing need to prioritize patient safety.


The Broader Movement For Patient Safety

The transition from "high-risk" to "high-alert" was part of a broader effort to enhance patient safety. Rather than simply labeling certain medications as dangerous, the healthcare community shifted towards building awareness and implementing practical strategies to prevent errors. This approach has proven essential in today’s fast-paced and complex healthcare environments, where medication management is a key factor in patient outcomes.


Conclusion

Molly's question was not just a moment of curiosity; it was a reminder of the importance of understanding the terminology and practices that shape the healthcare field. The shift from "high-risk" to "high-alert" medications reflects a critical evolution in healthcare, emphasizing the need for awareness, vigilance, and proactive measures. As students and future healthcare professionals, being informed about these changes allows us to contribute meaningfully to the ongoing conversation around patient safety. 


Thank you, Molly, for your engagement and for sparking such an essential discussion in our class!


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