Electronic Medication Management Systems' Influence on Hospital Pharmacists' Work Patterns

Abstract

Background: Implementation of electronic medication management systems (eMMS) are advocated to reduce medication errors, improve patient safety and impact on hospital pharmacists' work patterns. Aims: To quantify hospital pharmacists' distribution of their time and to identify differences in work patterns on wards with and without eMMS. Method: An observational time and motion study was conducted at a major Sydney teaching hospital. 8 pharmacists (3 on wards with eMMS, 5 on wards without eMMS) were observed on their wards for 37 hours. Distribution of tasks across work categories, mean task times, tasks performed with others and tasks using information tools, were calculated and compared between wards with and without eMMS. Results: Medication chart review was the most frequently performed task on both ward types. Pharmacists on eMMS wards had lower rates of interruptions (1/19.2 min vs 1/13.7 min) and multi-tasking (2.4% vs 8.7%) than non-eMMS wards. On eMMS wards, review activities were more frequent and faster, fewer 'in-transit' tasks occurred and more work was completed alone compared to non-eMMS wards. Patient care tasks took longer but occurred less often on eMMS wards. Pharmacists on eMMS wards spent more time clarifying medication orders but did it less often than pharmacists on non-eMMS wards. Conclusion: Pharmacists' work patterns in terms of task frequency, duration and location was different on the two ward types. Differences may be attributable to eMMS allowing easy and speedy access to information for reviews; shift away from the bedside to a computer terminal reducing tasks in-transit, interruptions and contact with patients and others; and improved clarity of medication orders reducing queries. J Pharm Pract Res 2010; 40: 106-10.

Hospital pharmacists’ perspectives on the role of key performance indicators in Australian pharmacy practice

“…12 This system may facilitate more robust and automated data collection without relying on staff reports. 12 To engage staff in the use of KPIs and reduce confusion regarding their role, the purpose and results from KPI collection should be communicated to the staff at all levels.…”

Impact of Computerized Provider Order Entry Systems on hospital staff pharmacist workflow productivity: A three site comparative analysis based on level of CPOE implementation

“…They found that pharmacists' work patterns varied significantly and attributed the changes to increased access to speedy and easy information retrieval for reviews and improved clarity regarding orders due to the presence of eMMS. [30] This factor could have played a part in the present study because in the present study, the CPOE sites had a significantly larger number of task changes per hour compared to the non-CPOE site. Because of this, even though the number of minutes spent on clinical tasks per hour decreased, the efficiency of clinical related tasks could have been increased, more than compensating for time loss.…”

Effects of an electronic medication management system on pharmacists’ work in a paediatric hospital

“…In an observational time‐and‐motion study undertaken in an Australian adult hospital, the work of pharmacists on wards that used paper‐based medication charts was compared with that of pharmacists on wards with an EMMS in place. Pharmacists on EMMS wards spent significantly less time reviewing medications, were interrupted less often and completed more tasks alone than pharmacists on non‐EMMS wards . The authors of that study suggested that these differences were likely to be a consequence of increased ease and speed of access to information, and a shift away from the bedside to computer terminals for medication chart access, reducing interruptions and contact with patients and other health professionals …”

“…Pharmacists on EMMS wards spent significantly less time reviewing medications, were interrupted less often and completed more tasks alone than pharmacists on non-EMMS wards. 10 The authors of that study suggested that these differences were likely to be a consequence of increased ease and speed of access to information, and a shift away from the bedside to computer terminals for medication chart access, reducing interruptions and contact with patients and other health professionals. 10 A small number of qualitative studies have explored pharmacists' perceptions of EMMS.…”

“…10 The authors of that study suggested that these differences were likely to be a consequence of increased ease and speed of access to information, and a shift away from the bedside to computer terminals for medication chart access, reducing interruptions and contact with patients and other health professionals. 10 A small number of qualitative studies have explored pharmacists' perceptions of EMMS. In a US multimethod study, pharmacists were surveyed before and after EMMS implementation, and were observed and interviewed following EMMS implementation to determine their satisfaction with the system and its effect on workflow.…”