Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study
نویسندگان
چکیده
BACKGROUND Medication error is a frequent, harmful and costly patient safety incident. Research to date has mostly focused on medication errors in hospitals. In this study, we aimed to identify the main causes of, and solutions to, medication error in primary care. METHODS We used a novel priority-setting method for identifying and ranking patient safety problems and solutions called PRIORITIZE. We invited 500 North West London primary care clinicians to complete an open-ended questionnaire to identify three main problems and solutions relating to medication error in primary care. 113 clinicians submitted responses, which we thematically synthesized into a composite list of 48 distinct problems and 45 solutions. A group of 57 clinicians randomly selected from the initial cohort scored these and an overall ranking was derived. The agreement between the clinicians' scores was presented using the average expert agreement (AEA). The study was conducted between September 2013 and November 2014. RESULTS The top three problems were incomplete reconciliation of medication during patient 'hand-overs', inadequate patient education about their medication use and poor discharge summaries. The highest ranked solutions included development of a standardized discharge summary template, reduction of unnecessary prescribing, and minimisation of polypharmacy. Overall, better communication between the healthcare provider and patient, quality assurance approaches during medication prescribing and monitoring, and patient education on how to use their medication were considered the top priorities. The highest ranked suggestions received the strongest agreement among the clinicians, i.e. the highest AEA score. CONCLUSIONS Clinicians identified a range of suggestions for better medication management, quality assurance procedures and patient education. According to clinicians, medication errors can be largely prevented with feasible and affordable interventions. PRIORITIZE is a new, convenient, systematic, and replicable method, and merits further exploration with a view to becoming a part of a routine preventative patient safety monitoring mechanism.
منابع مشابه
Identification of priorities for medication safety in the neonatal intensive care unit via failure mode and effect analysis
Prevention of medication errors in neonatal intensive care units (NICUs) is of paramount importance due to age-specific and physiological conditions of neonates. This study aimed to evaluate the risk of medication prescription and administration via failure mode and effects analysis (FMEA), which was carried out at the Research and Medical Teaching Center of Imam Reza Hospital in Mashhad, Iran....
متن کاملQuality and safety of medication use in primary care: consensus validation of a new set of explicit medication assessment criteria and prioritisation of topics for improvement
BACKGROUND Addressing the problem of preventable drug related morbidity (PDRM) in primary care is a challenge for health care systems internationally. The increasing implementation of clinical information systems in the UK and internationally provide new opportunities to systematically identify patients at risk of PDRM for targeted medication review. The objectives of this study were (1) to dev...
متن کاملIdentification of the Patient Requirements Using Lean Six Sigma and Data Mining
Lean health care is one of new managing approaches putting the patient at the core of each change. Lean construction is based on visualization for understanding and prioritizing imporvments. By using only visualization techniques, so much important information could be missed. In order to prioritize and select improvements, it’s essential to integrate new analysis tools to achieve a good unders...
متن کاملEvaluation of Prescriber Satisfaction in a University Testing Laboratory of Bacteriology
Background and Objectives: Given the growing concern focused on the continuous improvement of the quality of care, safety and customer satisfaction, the Ibn Sina University Hospital (CHIS) has started an ambitious program for institutionalization of quality management at the establishments under the CHIS, in general, and the ISO certification 9001v2008 of its biomedical analysis laboratories, i...
متن کاملPrioritizing medication safety in care of people with cancer: clinicians’ views on main problems and solutions
BACKGROUND Cancer care is liable to medication errors due to the complex nature of cancer treatment, the common presence of comorbidities and the involvement of a number of clinicians in cancer care. While the frequency of medication errors in cancer care has been reported, little is known about their causal factors and effective prevention strategies. With a unique insight into the main safety...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 17 شماره
صفحات -
تاریخ انتشار 2016