Reducing Medication Errors and Improving Systems Reliability Using an Electronic Medication Reconciliation System

Agrawal, Akshat; Wu, Winfred

doi:10.1016/s1553-7250(09)35014-x

Cited by 58 publications

(54 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The types and causes of medication discrepancies differed from those reported in the literature [17, [54][55][56][57][58]. This is most likely due to the fact that the majority of discrepancies in the present study were technology-related, while most published data refer to issues that are not technology-related.…”

Section: Discussioncontrasting

confidence: 76%

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Marien¹,

Legrand²,

Ramdoyal³

et al. 2017

Preprint

View full text Add to dashboard Cite

Background: Medication discrepancies consist of unexplained differences between medication lists at different transition points of care; they are a threat to patient safety. These discrepancies can be solved through medication reconciliation (MedRec), a complex and time-consuming process. Several approaches to optimizing MedRec have been encouraged, including the development of information technology (IT) tools and patient engagement. The SEAMPAT project aims to develop a MedRec IT platform based on two applications (one for the patient, the "patient app", the other for healthcare professionals), which were developed using a three-iteration user-centered design. The patient app presents the patient with a medication list compiled from different medication resources. Objective: To evaluate the usability and usefulness of the third iteration of the patient app, from the perspective of different categories of users, with the aims of making recommendations for wider use and informing further research. Methods: We performed a four-month user-centered observational study. After a kick-off session, patients, identified through purposive sampling, were invited to use the patient app at home, to update their medication lists whenever required. Quantitative and qualitative data were collected at different time points to evaluate three dimensions of usability (efficiency, satisfaction, and effectiveness), as well as usefulness. Participants completed two questionnaires on satisfaction and usefulness (including the system usability scale, SUS) at the kick-off and the end of the study. Effectiveness was assessed by measuring the completeness and correctness (i.e. medication discrepancies) of the final medication list generated by the patient application. Qualitative data were collected from observations at different time points and from semi-structured interviews at the end of the study. Results: Forty-eight patients agreed to participate and 42 completed the study, of whom 32 connected at least once to the application at home. Sixty-nine percent of patients considered the patient app to be acceptable (SUS Score ≥ 70) and perceived usefulness was high. The medication list was complete for a quarter of the patients and there was a median of two discrepancies per patient. The main causes were technology-related. The qualitative data enabled the identification of several barriers and, thus, of approaches to optimizing usability and usefulness. These relate to both functional (e.g. access, on-screen display, additional functionalities) and non-functional aspects (e.g. patient awareness, concordance between patient and physician) of the application. For future adoption of the tool, it will be important to address these issues. Conclusions: Our findings highlight the importance and value of user-centered usability testing of a patient application implemented in "real-world" conditions. We believe our study also underlines the need to take patients' points of view into consideration. To achieve adoption and sustained use by...

show abstract

Section: Discussioncontrasting

confidence: 76%

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

Marien¹,

Legrand²,

Ramdoyal³

et al. 2017

Preprint

View full text Add to dashboard Cite

show abstract

“…Following the intervention we reduced the incidence of UDs. This result is even more relevant if we take into consideration that the post-intervention population was composed of a greater proportion of people who were taking more than 10 drugs as their usual treatment, and also a greater proportion of people over the age of 65, both factors bring related to a greater probability of errors arising [13,14].…”

Section: Discussionmentioning

confidence: 98%

An opportunity for improvement with a medication reconciliation programme

Jiménez-Muñoz¹,

Zoni²,

Durán-García³

et al. 2013

OJIM

View full text Add to dashboard Cite

Medication reconciliation is priority in safety. Between 54% and 67% of hospitalized patients have at least one unintended discrepancies (UDs) between pharmacological treatment of a hospital inpatient and treatment that they were previously taking at home. Quasi-experimental pre-post study performed. The objective is to assess the impact of an intervention aimed at decreasing UDs between medication prescribed on admission and patient's regular treatment. Patients who were hospitalised for more than 24 hours and were undergoing treatment prior to admission which involved taking three or more medicines were included. The number of patients included was 331 and 3781 medicines were reconciled. The incidence of UDs decreased significantly from 7.24% to 4.18%. Omission was the most common UD, with a significant decrease from 5.8% to 3.4%. Respect to clinical impact, we observed that error type C (error reached patient without causing harm) predominates, however, experienced a statistically significant decrease from 5.3% to 2.4%.

show abstract

“…[5][6][7] A recent publication by PeaceHealth Medical Group describes a system-wide initiative to improve medication reconciliation in their ambulatory care clinics. The use of the EMR was an important tool in this initiative, as was clear collaboration between nursing staff and medical providers.…”

Section: Innovations In Pharmacymentioning

confidence: 99%

Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

Westberg¹,

Beeksma²

2010

Innov Pharm

View full text Add to dashboard Cite

show abstract

Reducing Medication Errors and Improving Systems Reliability Using an Electronic Medication Reconciliation System

Cited by 58 publications

References 24 publications

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

A web application to involve patients in the medication reconciliation process: a user-centered usability and usefulness study (Preprint)

An opportunity for improvement with a medication reconciliation programme

Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

Contact Info

Product

Resources

About