Learning from the design, development and implementation of the Medication Safety Thermometer

Rostami, Paryaneh; Power, Maxine; Harrison, Abigail; Bramfitt, Kurt; Williams, Steve; Jani, Yogini; Ashcroft, Darren M.; Tully, Mary P.

doi:10.1093/intqhc/mzw149

Cited by 14 publications

(48 citation statements)

References 33 publications

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“…In order for healthcare organisations to know if they are reducing medication-related harm, medication safety must be routinely measured to provide a baseline and to track improvement. In order to address the lack of routine medication safety data, England’s NHS introduced an improvement tool called the “Medication Safety Thermometer” (MedsST) in 2013 [ 2 ] and developed it via a large-scale multi-disciplinary collaborative, facilitated by Haelo (an independent innovation and improvement centre hosted by Salford Royal NHS Foundation Trust, England).…”

Section: Introductionmentioning

confidence: 99%

“…The MedsST consists of three steps to measure individual errors, triggers of harm and actual harm related to medication safety. Details of the MedsST tool and how it has been designed and developed are described in a previous paper [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, only regional and local financial incentives have been provided for organisations to use the MedsST. Only the Early Adopters (EA) of the MedsST (who joined the national programme during the alpha-testing phase, between January 2013 and March 2013) based in the Greater Manchester region, received a regional financial incentive for using the MedsST, between April 2013 and March 2014 [ 2 ]. The sole remaining EA organisation that was based outside of Greater Manchester, and Late Adopter (LA) organisations, who joined during the beta-testing phase or after (April 2013 onwards), have not received financial incentives unless they were agreed with their local commissioning groups [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Only the Early Adopters (EA) of the MedsST (who joined the national programme during the alpha-testing phase, between January 2013 and March 2013) based in the Greater Manchester region, received a regional financial incentive for using the MedsST, between April 2013 and March 2014 [ 2 ]. The sole remaining EA organisation that was based outside of Greater Manchester, and Late Adopter (LA) organisations, who joined during the beta-testing phase or after (April 2013 onwards), have not received financial incentives unless they were agreed with their local commissioning groups [ 2 ]. The availability of financial incentives is an external contextual factor [ 5 ], and one of many differing contextual variables regarding how the MedsST has been implemented and used in comparison to the original Safety Thermometer.…”

Section: Introductionmentioning

confidence: 99%

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A formative evaluation of the implementation of a medication safety data collection tool in English healthcare settings: A qualitative interview study using normalisation process theory

2018

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BackgroundReducing medication-related harm is a global priority; however, impetus for improvement is impeded as routine medication safety data are seldom available. Therefore, the Medication Safety Thermometer was developed within England’s National Health Service. This study aimed to explore the implementation of the tool into routine practice from users’ perspectives.MethodFifteen semi-structured interviews were conducted with purposely sampled National Health Service staff from primary and secondary care settings. Interview data were analysed using an initial thematic analysis, and subsequent analysis using Normalisation Process Theory.ResultsSecondary care staff understood that the Medication Safety Thermometer’s purpose was to measure medication safety and improvement. However, other uses were reported, such as pinpointing poor practice. Confusion about its purpose existed in primary care, despite further training, suggesting unsuitability of the tool. Decreased engagement was displayed by staff less involved with medication use, who displayed less ownership. Nonetheless, these advocates often lacked support from management and frontline levels, leading to an overall lack of engagement. Many participants reported efforts to drive scale-up of the use of the tool, for example, by securing funding, despite uncertainty around how to use data. Successful improvement was often at ward-level and went unrecognised within the wider organisation. There was mixed feedback regarding the value of the tool, often due to a perceived lack of “capacity”. However, participants demonstrated interest in learning how to use their data and unexpected applications of data were reported.ConclusionRoutine medication safety data collection is complex, but achievable and facilitates improvements. However, collected data must be analysed, understood and used for further work to achieve improvement, which often does not happen. The national roll-out of the tool has accelerated shared learning; however, a number of difficulties still exist, particularly in primary care settings, where a different approach is likely to be required.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A formative evaluation of the implementation of a medication safety data collection tool in English healthcare settings: A qualitative interview study using normalisation process theory

2018

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“…Quality improvement efforts by National Health Services (NHS) in the United Kingdom (UK) have led to the design, development and implementation of a 'Medication Safety Thermometer' (Rostami, et al, 2017). This approach to improve safety requires data on harm and potential harm related to medication be collected one day per month and the data is then used to inform and monitor efforts to improve medication safety.…”

Section: Medication Errors and Adverse Drug Eventsmentioning

confidence: 99%

Incorporating business process management, business ontology and business architecture in medication management quality

Urquhart¹

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Managers and care providers in the health sector are expected to deliver safe, efficient and effective services within a resource constrained, complex system. Services are provided through execution of multiple processes. Healthcare organizations tend to be structured in functional based silos with process improvement efforts often focused on individual processes within the discrete silos. This silo based improvement approach fails to take into account upstream and downstream processes executed and managed in other silos. A patient's journey will typically include processes from multiple silos and therefore, improvement efforts need to focus on end-to-end processes if the goal is to deliver a positive patient experience. In order to optimize processes in a complex adaptive system like healthcare and to effect meaningful change a combination of management disciplines is required. This research explored the use of Business Process Management (BPM), Business Architecture (BA) and Business Process Management Ontology (BPMO) as a comprehensive, integrated approach to design, redesign, evaluate, improve and monitor the safety, efficiency and effectiveness of medication management processes in a multi-site healthcare organization. The contribution of the research was threefold. First, identified benefits of applying BPM, BPMO and BA to increase organization capacity and improve the end-to-end process of medication management; second, demonstrated the application of an ontology and the business layer of enterprise architecture used in other sectors could be successfully utilized in the healthcare sector; and third, developed a process reference model for medication management processes in acute care and long term care facilities.

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Lean Methodology in the Process of Prescribing and Administering Therapeutics in the Intensive Care Unit

Marques

Sousa

Cortes³

et al. 2021

Lecture Notes in Bioengineering

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Objective: This study was conducted to explore and to describe the causes of medication errors in Intensive Care Units (ICUs) from the perspective of physicians, nurses, and clinical pharmacists. Methods: The study was conducted using a descriptive qualitative method in 2016. We included 16 ICUs of seven educational hospitals affiliated to Isfahan University of Medical Sciences. Participants included 19 members of the healthcare team (physician, nurse, and clinical pharmacist) with at least 1 year of work experience in the ICUs. Participants were selected using purposeful sampling method. Data were collected through semi-structured individual interviews and were used for qualitative content analysis. Findings: The four main categories and ten subcategories were extracted from interviews. The four categories were as follows: "low attention of healthcare professionals to medication safety," "lack of professional communication and collaboration," "environmental determinants," and "management determinants." Conclusion: Incorrect prescribing of physicians, unsafe drug administration of nurses, the lack of pharmaceutical knowledge of the healthcare team, and the weak professional collaboration lead to medication errors. To improve patient safety in the ICUs, healthcare center managers need to promote interprofessional collaboration and participation of clinical pharmacists in the ICUs. Furthermore, interprofessional programs to prevent and reduce medication errors should be developed and implemented.

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Learning from the design, development and implementation of the Medication Safety Thermometer

Cited by 14 publications

References 33 publications

A formative evaluation of the implementation of a medication safety data collection tool in English healthcare settings: A qualitative interview study using normalisation process theory

A formative evaluation of the implementation of a medication safety data collection tool in English healthcare settings: A qualitative interview study using normalisation process theory

Incorporating business process management, business ontology and business architecture in medication management quality

Lean Methodology in the Process of Prescribing and Administering Therapeutics in the Intensive Care Unit

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