‘Our surgeons want this to be short and simple’: practices of in-hospital medication review as coordinated sociomaterial actions

Abstract

Medication review, a systematic assessment of a patient's medicines by a health care professional, is intended to prevent medicationrelated harms. A critical element of medication review concerns whether medication review is conducted in a coordinated way. This article draws from a case example of implementing medication review in two surgical wards of a Swedish regional hospital and aims to analyse how medication review is being accomplished with respect to the coordination of its actions. Using a practice-based ethnographic approach, we present several coordination mechanisms by illustrating how practices are connected to materials involved in medication review. Also, we show how common orientations, ends, and understandings expressed in different medication review practices contribute to the coordination of the practices. In conclusion, this article highlights the complexity of establishing and sustaining medication review as a coordinated practice in routine health care. By closely examining sociomaterial connections, this article sheds new light on the neglected issue of artefacts and arrangements in constituting and transforming a highly complex medication practice.

Embedding hospital-based medication review

“…This work is part of a larger ethnographic study exploring practitioners' practice understandings and everyday enactments of medication review in a hospital context (Reichenpfader et al, 2018a;Reichenpfader et al, 2018b). This article draws on two cases of different organizational clinical units at two teaching hospitals in southern Sweden (a department of surgery and an emergency department, ED).…”

‘In the hospital all is taken care of’: a practice‐theoretical approach to understand patients’ medication use

“…Data used in this article were collected as part of broader ethnographic study exploring the local implementation of medication review in the southeast of Sweden (Reichenpfader et al . ,). Ethical approval was granted by the Regional Ethics Board (ref.…”

“…A focus was put on healthcare professionals engaging in ward rounds, handoffs or briefings, but also on clinician–patient encounters (Reichenpfader et al . ,). Further patients were approached at the department of orthopaedics at the same hospital where the surgical department was located.…”