Learning to work with electronic patient records and prescription charts: experiences and perceptions of hospital pharmacists

Burgin, A.; O’Rourke, Rebecca; Tully, Mary P.

doi:10.1016/j.sapharm.2013.11.005

Cited by 22 publications

(32 citation statements)

References 27 publications

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“…Several of the new or changed tasks associated with EMMS introduction described by pharmacists in this study are consistent with those reported in previous research . The requirement to be more vigilant to ensure that all components of a medication order are correct and the requirement to train doctors on how to use the EMMS were both new tasks reported in a US study .…”

Section: Discussionsupporting

confidence: 86%

“…With pharmacists frequently acting as informal trainers on EMMS, they require training on all features and functions, even those not typically used by pharmacists. Finally, the location of work shifting from the beside to other areas was a consequence of EMMS also reported by pharmacists in a UK study …”

Section: Discussionsupporting

confidence: 53%

“…Finally, the location of work shifting from the beside to other areas was a consequence of EMMS also reported by pharmacists in a UK study. 12 Where the present study differs from previous research is in its identification of obstacles preventing streamlined and efficient pharmacy workflow. A number of the problems identified by pharmacists appear to be the result of the EMMS not supporting how work was undertaken prior to system implementation.…”

Section: Discussionmentioning

confidence: 84%

“…Several of the new or changed tasks associated with EMMS introduction described by pharmacists in this study are consistent with those reported in previous research. 11,12 The requirement to be more vigilant to ensure that all components of a medication order are correct and the requirement to train doctors on how to use the EMMS were both new tasks reported in a US study. 11 Insufficient training for pharmacists was also identified as a highly significant issue in that US study, with pharmacists expressing a need for training regarding other clinician tasks, such as prescribing.…”

Section: Discussionmentioning

confidence: 99%

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

Baysari

Hardie

Barclay

et al. 2019

Pharmacy Practice and Res

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Background Many studies have explored the effect of electronic medication management systems (EMMS) on doctors’ and nurses’ work, but few have focused specifically on pharmacists’ work. Aim This study examined how implementation of a commercial EMMS affected the work of pharmacists in an Australian paediatric hospital. In particular, the study investigated whether any pharmacy tasks changed or were eliminated, or whether new tasks emerged following EMMS introduction. Methods Two rounds of semistructured interviews with pharmacists, one 4 months and the other 1 year after EMMS implementation, were conducted. In total, 17 pharmacists were interviewed, comprising inpatient, outpatient and oncology pharmacists, as well as pharmacy managers. Results EMMS implementation eliminated a small number of tasks, changed some tasks and created many new work tasks for pharmacists. These new tasks included helping doctors and nurses to use the EMMS, duplicated data entry and the review of additional information. Pharmacists held the view that their workload had increased and that additional pharmacists were necessary to cope with the new work requirements associated with the EMMS. Some problems were perceived to be the result of implementation of a US‐designed EMMS that did not fully support Australian pharmacy workflows. Conclusion Implementation of an EMMS in a paediatric hospital affected pharmacists’ work in a variety of ways, predominately by introducing new tasks. Anticipating how workflows will change with EMMS implementation is challenging. Undertaking regular reviews of workflow and planning for an increased burden on pharmacy staff is likely to improve the transition from paper to electronic medication management.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Baysari

Hardie

Barclay

et al. 2019

Pharmacy Practice and Res

View full text Add to dashboard Cite

show abstract

“…It has been acknowledged that implementation of eMMS results in significant changes to pharmacist workflow, but this also presents medical staff and pharmacists with opportunities for collaborative models of medication prescribing and charting . In contrast to paper‐based charts, these systems allow for detailed levels of transparency and for staff to review charts remotely.…”

Section: Introductionmentioning

confidence: 99%

Impact of proactive pharmacist‐assisted warfarin management using an electronic medication management system in Australian hospitalised patients

Tyedin

Taylor

Than

et al. 2020

Pharmacy Practice and Res

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Aim: To evaluate whether pharmacist-assisted electronic warfarin charting and monitoring reduces warfarin-related errors and improves post-discharge continuum of care. Method: Cardiology and medical patients admitted for at least 24 h and prescribed at least one warfarin dose were included in a pre/post-intervention study. The intervention involved pharmacists proactively charting warfarin and ordering international normalised ratios (INRs) using electronic prescribing software, following discussion with medical doctors. Endpoints included: percentage of patients with one or more warfarin errors, INR > 5.0 during admission, readmission within 30 days for anticoagulant-related issues and warfarin discharge plan (WDP) completeness (including documentation of next dose/s, and when and where the next INR was to be checked). Results: Pre-and post-intervention groups comprised 130 and 108 patients, respectively. Post-intervention, more patients received warfarin following heart valve replacement and fewer for venous thromboembolism. Post-intervention, pharmacists ordered 130 doses (72 patients) and 98 INRs (59 patients). Percentage of patients with one or more warfarin errors declined from 27.7 to 7.4% (p < 0.01), with INR> 5.0 decreased from 7.7 to 2.8% (p = 0.17) and readmission within 30 days for anticoagulation problems occurred in 4 and 0 cases pre-and post-intervention, respectively. While there was a non-significant decline in the proportion of patients with a WDP post-intervention, when patients had a WDP it was more comprehensively completed (p < 0.01). Conclusion: Pharmacists proactively charting and monitoring warfarin reduced warfarin-related errors during hospitalisation and improved elements of post-discharge communication. Closer multi-disciplinary communication and 7-day pharmacy services may result in further continuum of care improvements.

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A cross-country time and motion study to measure the impact of electronic medication management systems on the work of hospital pharmacists in Australia and England

Westbrook

Shah

et al. 2019

International Journal of Medical Informatics

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Background: Qualitative studies have provided important insights into how hospital pharmacists' work changes when electronic medication management (EMM) systems are introduced. Quantitative studies of work practice change are rare. Despite the use of EMM systems internationally, there are no crosscountry comparative studies of their impact on health professionals' work. We aimed to quantify and compare the type and magnitude of changes in hospital pharmacists' work pre-and post-EMM implementation in two countries. Methods: Parallel, direct observational, time and motion studies of pharmacists in Australia and England pre-and post-EMM implementation. 20 pharmacists were observed: 9 in an Australian 440-bed hospital (155 hours); and 11 pharmacists in a 500-bed English hospital (258 hours). The Work Observation Method By Activity Timing (WOMBAT) software was used to collect observational data. Proportions of observed time in 11 tasks by study period (pre-versus post-EMM) and site, time spent with others or alone, and using different tools (e.g computers, paper) were calculated. Magnitude of changes between pre-and post-EMM by task and country were determined using z-tests for proportions adjusting for multiple testing. Results: At baseline, Australian and English pharmacists spent the greatest proportion of time in medication review. Post-EMM, time in medication review (Australia 21.6% to 27.5%; England 27.1% to 33.8%) and history-taking (Australia 7.6% to 13.3%; England 19.5% to 28.9%) significantly increased. Despite country differences in these tasks at baseline, the magnitude of changes did not significantly differ. English pharmacists increased time engaged in medication discussions with patients post-EMM (from 5.9% to 10.8%; p=0.01). The Australian rate did not change (18.0% to 27.2%; p=0.09), but was higher at baseline. Post-EMM, Australian pharmacists spent 63.4% of time working alone, compared to 92.0% for English pharmacists. Conclusions: EMM systems impacted the same core areas of work and had a similar magnitude of effect on pharmacists' work in both countries. Anticipated reductions in medication review and history taking were not observed.

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Learning to work with electronic patient records and prescription charts: experiences and perceptions of hospital pharmacists

Cited by 22 publications

References 27 publications

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

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

Impact of proactive pharmacist‐assisted warfarin management using an electronic medication management system in Australian hospitalised patients

A cross-country time and motion study to measure the impact of electronic medication management systems on the work of hospital pharmacists in Australia and England

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