scholarly journals 097IMPACT OF A BESPOKE MEDICATION MANAGEMENT SYSTEM ON MEDICATION SAFETY IN AN IRISH NURSING HOME

2016 ◽  
Vol 45 (suppl 2) ◽  
pp. ii13.14-ii56
Author(s):  
Anne Marie O'Regan ◽  
Neil Mackay ◽  
Michael O'Connor ◽  
Margaret Bermingham
Keyword(s):  
Nursing Home ◽  
Management System ◽  
Medication Safety ◽  
Medication Management

scholarly journals Opportunities and Recommendations for Improving Medication Safety: Understanding the Medication Management System in Primary Care Through an Abstraction Hierarchy (Preprint)

2020 ◽  
Author(s):  
Andrew Baumgartner ◽  
Taylor Kunkes ◽  
Collin M Clark ◽  
Laura A Brady ◽  
Scott V Monte ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Human Factors ◽  
Health Care System ◽  
Management System ◽  
Medication Safety ◽  
Medication Management ◽  
Potentially Inappropriate Medications ◽  
Primary Care Office ◽  
Care System

BACKGROUND Despite making great strides in improving the treatment of diseases, the minimization of unintended harm by medication therapy continues to be a major hurdle facing the health care system. Medication error and prescription of potentially inappropriate medications (PIMs) represent a prevalent source of harm to patients and are associated with increased rates of adverse events, hospitalizations, and increased health care costs. Attempts to improve medication management systems in primary care have had mixed results. Implementation of new interventions is difficult because of complex contextual factors within the health care system. Abstraction hierarchy (AH), the first step in cognitive work analysis (CWA), is used by human factors practitioners to describe complex sociotechnical systems. Although initially intended for the nuclear power domain and interface design, AH has been used successfully to aid the redesign of numerous health care systems such as the design of decision support tools, mobile patient monitoring apps, and a telephone triage system. OBJECTIVE This paper aims to refine our understanding of the primary care office in relation to a patient’s medication through the development of an AH. Emphasis was placed on the elements related to medication safety to provide guidance for the design of a safer medication management system in primary care. METHODS The AH development was guided by the methodology used by seminal CWA literature. It was initially developed by 2 authors and later fine-tuned by an expert panel of clinicians, social scientists, and a human factors engineer. It was subsequently refined until an agreement was reached. A means-ends analysis was performed and described for the nodes of interest. The model represents the primary care office space through functional purposes, values and priorities, function-related purposes, object-related processes, and physical objects. RESULTS This model depicts the medication management system at various levels of abstraction. The resulting components must be balanced and coordinated to provide medical treatment with limited health care resources. Understanding the physical and informational constraints on activities that occur in a primary care office depicted in the AH defines areas in which medication safety can be improved. CONCLUSIONS Numerous means-ends relationships were identified and analyzed. These can be further evaluated depending on the specific needs of the user. Recommendations for optimizing a medication management system in a primary care facility were made. Individual practices can use AH for clinical redesign to improve prescribing and deprescribing practices.

scholarly journals Medication safety incidents in paediatric oncology after electronic medication management system implementation

2019 ◽  
Vol 28 (6) ◽  
Author(s):  
Valentina Lichtner ◽  
Melissa Baysari ◽  
Peter Gates ◽  
Luciano Dalla‐Pozza ◽  
Johanna I. Westbrook
Keyword(s):  
Management System ◽  
Medication Safety ◽  
Medication Management ◽  
Paediatric Oncology ◽  
System Implementation

scholarly journals Opportunities and Recommendations for Improving Medication Safety: Understanding the Medication Management System in Primary Care Through an Abstraction Hierarchy

10.2196/18103 ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. e18103
Author(s):  
Andrew Baumgartner ◽  
Taylor Kunkes ◽  
Collin M Clark ◽  
Laura A Brady ◽  
Scott V Monte ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Human Factors ◽  
Health Care System ◽  
Management System ◽  
Medication Safety ◽  
Medication Management ◽  
Potentially Inappropriate Medications ◽  
Primary Care Office ◽  
Care System

Background Despite making great strides in improving the treatment of diseases, the minimization of unintended harm by medication therapy continues to be a major hurdle facing the health care system. Medication error and prescription of potentially inappropriate medications (PIMs) represent a prevalent source of harm to patients and are associated with increased rates of adverse events, hospitalizations, and increased health care costs. Attempts to improve medication management systems in primary care have had mixed results. Implementation of new interventions is difficult because of complex contextual factors within the health care system. Abstraction hierarchy (AH), the first step in cognitive work analysis (CWA), is used by human factors practitioners to describe complex sociotechnical systems. Although initially intended for the nuclear power domain and interface design, AH has been used successfully to aid the redesign of numerous health care systems such as the design of decision support tools, mobile patient monitoring apps, and a telephone triage system. Objective This paper aims to refine our understanding of the primary care office in relation to a patient’s medication through the development of an AH. Emphasis was placed on the elements related to medication safety to provide guidance for the design of a safer medication management system in primary care. Methods The AH development was guided by the methodology used by seminal CWA literature. It was initially developed by 2 authors and later fine-tuned by an expert panel of clinicians, social scientists, and a human factors engineer. It was subsequently refined until an agreement was reached. A means-ends analysis was performed and described for the nodes of interest. The model represents the primary care office space through functional purposes, values and priorities, function-related purposes, object-related processes, and physical objects. Results This model depicts the medication management system at various levels of abstraction. The resulting components must be balanced and coordinated to provide medical treatment with limited health care resources. Understanding the physical and informational constraints on activities that occur in a primary care office depicted in the AH defines areas in which medication safety can be improved. Conclusions Numerous means-ends relationships were identified and analyzed. These can be further evaluated depending on the specific needs of the user. Recommendations for optimizing a medication management system in a primary care facility were made. Individual practices can use AH for clinical redesign to improve prescribing and deprescribing practices.

scholarly journals Drug therapy problems identified among older adults placed in a nursing home: the Croatian experience

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092879
Author(s):  
Katarina Fehir Šola ◽  
Iva Mucalo ◽  
Andrea Brajković ◽  
Ivona Jukić ◽  
Donatella Verbanac ◽  
...  
Keyword(s):  
Nursing Home ◽  
Drug Therapy ◽  
Medication Management ◽  
Institutional Care ◽  
Nursing Home Residents ◽  
Median Number ◽  
Cross Sectional ◽  
High Prevalence ◽  
Care Facilities ◽  
Drug Therapy Problems

Objective The aim of this study was to determine the frequency and type of drug therapy problems (DTPs) in older institutionalized adults. Method We conducted a cross-sectional observational study from February to June 2016 at a 150-bed public nursing home in Croatia, where comprehensive medication management (CMM) services were provided. A rational decision-making process, referred to as the Pharmacotherapy Workup method, was used to classify DTPs. Results Data were prospectively collected from 73 residents, among which 71% were age 75 years or older. The median number of prescribed medications per patient was 7 (2–16) and polypharmacy (> 4) was recorded for 54 (74.0%) patients. A total 313 DTPs were identified, with an average of 4.3 ± 2 DTPs per patient. The most frequent DTP was needing additional drug therapy (n = 118; 37.7%), followed by adverse drug reaction (n = 55; 17.6%). Lactulose (14.4%), tramadol (6.7%), and potassium (6.4%) were the medications most frequently related to DTPs. Conclusion The high prevalence of DTPs identified among older institutionalized adults strongly suggests the need to incorporate new pharmacist-led CMM services within existing institutional care facilities, to improve the care provided to nursing home residents.

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

2019 ◽  
Vol 49 (4) ◽  
pp. 317-323
Author(s):  
Melissa T. Baysari ◽  
Rae‐Anne Hardie ◽  
Peter Barclay ◽  
Johanna I. Westbrook
Keyword(s):  
Management System ◽  
Medication Management ◽  
Paediatric Hospital

scholarly journals A Comprehensive Medicine Management System with Multiple Sources in a Nursing Home in Taiwan

2016 ◽  
Vol E99.D (6) ◽  
pp. 1447-1454 ◽  
Author(s):  
Liang-Bi CHEN ◽  
Wan-Jung CHANG ◽  
Kuen-Min LEE ◽  
Chi-Wei HUANG ◽  
Katherine Shu-Min LI
Keyword(s):  
Nursing Home ◽  
Management System ◽  
Multiple Sources ◽  
Medicine Management

Medication Management System Design for Isolated Patient Care

2020 ◽  
Author(s):  
Samhith Kethireddy Abigail Swamidoss ◽  
Bushra Alghamdi ◽  
Ronald L. Hickman ◽  
Shanina Knighton ◽  
Miriam Pekarek ◽  
...  
Keyword(s):  
System Design ◽  
Language Processing ◽  
Management System ◽  
Classification Tree ◽  
Medication Management ◽  
Care Providers ◽  
Medication Regimen ◽  
Dynamic Framework ◽  
Medication Schedule ◽  
Number Of Patients

Abstract Independent living care for polypharmacy patients can be complicated in those situations with medications that are pro re nata (PRN, “as needed”). Such medication regimen may involve multiple dosing whereby specific drug contraindications might be easily overlooked by hospice and palliative care patients, or by those isolated and not in regular contact with care providers. The goal of this paper is to describe the development steps and current design of a system providing medication decision support for isolated patients. With an increased number of patients living alone or isolated - a situation exacerbated during the COVID19 pandemic – polypharmacy patients may be challenged when PRN (as needed) medications confound what might ordinarily be a routine medication schedule. Central to our medication management system design is the so-called “conversational agent” that when integrated with a natural language processing front- end and classification tree algorithm provide a dynamic framework for patient self-management of medications. Research on “patient need” revealed patients were more likely to embrace the system if the system were autonomous, secure, and not cloud-based.

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