Richard Williams1, Richard Keers2, Wouter T Gude3, Mark Jeffries4, Colin Davies5, Benjamin Brown6, Evangelos Kontopantelis7, Anthony J Avery8, Darren M Ashcroft9, Niels Peek10. 1. NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC), University of Manchester. richard.williams2@manchester.ac.uk. 2. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK and Division of Pharmacy and Optometry, Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester. richard.keers@manchester.ac.uk. 3. Wouter T. Gude Academic Medical Center, University of Amsterdam. w.t.gude@amc.uva.nl. 4. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and Division of Pharmacy and Optometry, Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester. mark.jefferies@manchester.ac.uk. 5. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and MRC Health eResearch Centre, Division of Informatics, Imaging and Data Science, University of Manchester,. colin.fficol@gmail.com. 6. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and MRC Health eResearch Centre, Division of Informatics, Imaging and Data Science, University of Manchester. benjamin.brown@manchester.ac.uk. 7. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and NIHR School for Primary Care Research, University of Manchester. E.Kontopantelis@manchester.ac.uk. 8. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and School of Medicine, University of Nottingham. Anthony.Avery@nottingham.ac.uk. 9. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and Division of Pharmacy and Optometry, Centre for Pharmacoepidemiology and Drug Safety, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester. Darren.Ashcroft@manchester.ac.uk. 10. NIHR Greater Manchester Patient Safety Translational Research Centre, University of Manchester; UK and MRC Health eResearch Centre, Division of Informatics, Imaging and Data Science, University of Manchester. niels.peek@manchester.ac.uk.
Abstract
BACKGROUND: Patient safety is vital to well-functioning health systems. A key component is safe prescribing, particularly in primary care where most medications are prescribed. Previous research demonstrated that the number of patients exposed to potentially hazardous prescribing can be reduced by interrogating the electronic health record (EHR) database of general practices and providing feedback to general practitioners in a pharmacist-led intervention. We aimed to develop and roll out an online dashboard application that delivers this audit and feedback intervention in a continuous fashion. METHOD: Based on initial system requirements we designed the dashboard's user interface over 3 iterations with 6 general practitioners (GPs), 7 pharmacists and a member of the public. Prescribing safety indicators from previous work were implemented in the dashboard. Pharmacists were trained to use the intervention and deliver it to general practices. RESULTS: A web-based electronic dashboard was developed and linked to shared care records in Salford, UK. The completed dashboard was deployed in all but one (n=43) general practices in the region. By November 2017, 36 pharmacists had been trained in delivering the intervention to practices. There were 135 registered users of the dashboard, with an average of 91 user sessions a week. CONCLUSION: We have developed and successfully rolled out of a complex, pharmacist-led dashboard intervention in Salford, UK. System usage statistics indicate broad and sustained uptake of the intervention. The use of systems that provide regularly updated audit information may be an important contributor towards medication safety in primary care.
BACKGROUND:Patient safety is vital to well-functioning health systems. A key component is safe prescribing, particularly in primary care where most medications are prescribed. Previous research demonstrated that the number of patients exposed to potentially hazardous prescribing can be reduced by interrogating the electronic health record (EHR) database of general practices and providing feedback to general practitioners in a pharmacist-led intervention. We aimed to develop and roll out an online dashboard application that delivers this audit and feedback intervention in a continuous fashion. METHOD: Based on initial system requirements we designed the dashboard's user interface over 3 iterations with 6 general practitioners (GPs), 7 pharmacists and a member of the public. Prescribing safety indicators from previous work were implemented in the dashboard. Pharmacists were trained to use the intervention and deliver it to general practices. RESULTS: A web-based electronic dashboard was developed and linked to shared care records in Salford, UK. The completed dashboard was deployed in all but one (n=43) general practices in the region. By November 2017, 36 pharmacists had been trained in delivering the intervention to practices. There were 135 registered users of the dashboard, with an average of 91 user sessions a week. CONCLUSION: We have developed and successfully rolled out of a complex, pharmacist-led dashboard intervention in Salford, UK. System usage statistics indicate broad and sustained uptake of the intervention. The use of systems that provide regularly updated audit information may be an important contributor towards medication safety in primary care.
Entities:
Keywords:
Patient safety; dashboard; drug prescriptions; electronic audit & feedback
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Authors: Niels Peek; Wouter T Gude; Richard N Keers; Richard Williams; Evangelos Kontopantelis; Mark Jeffries; Denham L Phipps; Benjamin Brown; Anthony J Avery; Darren M Ashcroft Journal: PLoS Med Date: 2020-10-13 Impact factor: 11.069