Evaluation of features to support safety and quality in general practice clinical software

Sweidan, Michelle; Williamson, Margaret; Reeve, James F; Harvey, Ken; O'Neill, Jennifer A.; Schattner, Peter; Snowdon, Teri

doi:10.1186/1472-6947-11-27

Cited by 15 publications

(10 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thirty-six studies evaluating interventions to prevent errors in primary care were reviewed -computerisation including provider order entry systems, electronic prescribing, clinical decision support/clinical alerts and electronic health records, [12,13,59,[61][62][63][64][65][66][70][71][72]89] personal digital assistants, [67] educational outreach and prescribing support, [14,65,[74][75][76][77][78][79]90] formularies, [74,75] pharmacist-led interventions, [72,74,[80][81][82] barcode systems, [84] medication reconciliation and patient engagement, [85,86,91,92] and quality management strategies [87] (Table 3).…”

Section: Interventions To Reduce Medication Errors In Primary Carementioning

confidence: 99%

Safety of medication use in primary care

Olaniyan

Ghaleb

Dhillon

et al. 2014

International Journal of Pharmacy Practice

View full text Add to dashboard Cite

Keywords AbstractBackground Medication errors are one of the leading causes of harmin health care. Review and analysis of errors have often emphasized their preventable nature and potential for reoccurrence. Of the few error studies conducted in primary care to date, most have focused on evaluating individual parts of the medicines management system. Studying individual parts of the system does not provide a complete perspective and may further weaken the evidence and undermine interventions. Aim and Objectives The aim of this review is to estimate the scale of medication errors as a problem across the medicines management system in primary care. Objectives were: 1. To review studies addressing the rates of medication errors, and 2. To identify studies on interventions to prevent medication errors in primary care. Methods A systematic search of the literature was performed in PubMed (MEDLINE), International Pharmaceutical Abstracts (IPA), Embase, PsycINFO, PASCAL, Science Direct, Scopus, Web of Knowledge, and CINAHL PLUS from 1999 to November, 2012. Bibliographies of relevant publications were searched for additional studies. Key findings Thirty-three studies estimating the incidence of medication errors and thirty-six studies evaluating the impact of error-prevention interventions in primary care were reviewed. This review demonstrated that medication errors are common, with error rates between <1% and >90%, depending on the part of the system studied, and the definitions and methods used. The prescribing stage is the most susceptible, and that the elderly (over 65 years), and children (under 18 years) are more likely to experience significant errors. Individual interventions demonstrated marginal improvements in medication safety when implemented on their own. Conclusion Targeting the more susceptible population groups and the most dangerous aspects of the system may be a more effective approach to error management and prevention. Co-implementation of existing interventions at points within the system may offer time-and cost-effective options to improving medication safety in primary care.

show abstract

Section: Interventions To Reduce Medication Errors In Primary Carementioning

confidence: 99%

Safety of medication use in primary care

Olaniyan

Ghaleb

Dhillon

et al. 2014

International Journal of Pharmacy Practice

View full text Add to dashboard Cite

show abstract

“…The electronic prescription of medicines (e-prescribing) is now routine, [1] making the clinical decision support (CDS) systems they include [2] amongst the most common encountered by clinicians. CDS can help reduce adverse events by displaying alerts for potential errors such as drug-drug interactions [3–5].…”

Section: Introductionmentioning

confidence: 99%

“…For e-prescribing systems, decision support is commonly provided in the form of alerts that warn clinicians about potential prescribing errors [2]. Despite such alerts being one of the most common forms of decision support, the high volume of prescriptions ordered, and risk of harm to patients from prescribing errors, no studies have yet assessed the risk of AB in e-prescribing.…”

Section: Introductionmentioning

confidence: 99%

Automation bias in electronic prescribing

Lyell

Magrabi

Raban

et al. 2017

BMC Med Inform Decis Mak

View full text Add to dashboard Cite

BackgroundClinical decision support (CDS) in e-prescribing can improve safety by alerting potential errors, but introduces new sources of risk. Automation bias (AB) occurs when users over-rely on CDS, reducing vigilance in information seeking and processing. Evidence of AB has been found in other clinical tasks, but has not yet been tested with e-prescribing. This study tests for the presence of AB in e-prescribing and the impact of task complexity and interruptions on AB.MethodsOne hundred and twenty students in the final two years of a medical degree prescribed medicines for nine clinical scenarios using a simulated e-prescribing system. Quality of CDS (correct, incorrect and no CDS) and task complexity (low, low + interruption and high) were varied between conditions. Omission errors (failure to detect prescribing errors) and commission errors (acceptance of false positive alerts) were measured.ResultsCompared to scenarios with no CDS, correct CDS reduced omission errors by 38.3% (p < .0001, n = 120), 46.6% (p < .0001, n = 70), and 39.2% (p < .0001, n = 120) for low, low + interrupt and high complexity scenarios respectively. Incorrect CDS increased omission errors by 33.3% (p < .0001, n = 120), 24.5% (p < .009, n = 82), and 26.7% (p < .0001, n = 120). Participants made commission errors, 65.8% (p < .0001, n = 120), 53.5% (p < .0001, n = 82), and 51.7% (p < .0001, n = 120). Task complexity and interruptions had no impact on AB.ConclusionsThis study found evidence of AB omission and commission errors in e-prescribing. Verification of CDS alerts is key to avoiding AB errors. However, interventions focused on this have had limited success to date. Clinicians should remain vigilant to the risks of CDS failures and verify CDS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-017-0425-5) contains supplementary material, which is available to authorized users.

show abstract

“…There are advantages of EHRs over traditional paperbased records as regards legibility, accessibility and automation of repeated tasks. Consequently, there is the potential to increase time spent on direct patient care (1,53,55,58,(60)(61)(62)(63). However, some time studies have failed to demonstrate any noticeable increase of the time spent on clinician-patient encounters (64)(65)(66)(67).…”

Section: Discussionmentioning

confidence: 99%