Risks in the analogue and digitally-supported medication process and potential solutions to increase patient safety in the hospital: A mixed methods study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 07 07 2023
accepted: 05 01 2024
medline: 27 2 2024
pubmed: 27 2 2024
entrez: 27 2 2024
Statut: epublish

Résumé

In hospital medication errors are common. Our aim was to investigate risks of the analogue and digitally-supported medication process and any potential solutions. A mixed methods study including a structured literature search and online questionnaires based on the Delphi method was conducted. First, all risks were structured into main and sub-risks and second, risks were grouped into risk clusters. Third, healthcare experts assessed risk clusters regarding their likelihood of occurrence their possible impact on patient safety. Experts were also asked to estimate the potential for digital solutions and solutions that strengthen the competence of healthcare professionals. Overall, 160 main risks and 542 sub-risks were identified. Main risks were grouped into 43 risk clusters. 33 healthcare experts (56% female, 50% with >20 years professional-experience) ranked the likelihood of occurrence and the impact on patient safety in the top 15 risk clusters regarding the process steps: admission (n = 4), prescribing (n = 3), verifying (n = 1), preparing/dispensing (n = 3), administering (n = 1), discharge (n = 1), healthcare professional competence (n = 1), and patient adherence (n = 1). 28 healthcare experts (64% female, 43% with >20 years professional-experience) mostly suggested awareness building and training, strengthened networking, and involvement of pharmacists at point-of-care as likely solutions to strengthen healthcare professional competence. For digital solutions they primarily suggested a digital medication list, digital warning systems, barcode-technology, and digital support in integrated care. The medication process holds a multitude of potential risks, in both the analogue and the digital medication process. Different solutions to strengthen healthcare professional competence and in the area of digitalization were identified that could help increase patient safety and minimize possible errors.

Sections du résumé

BACKGROUND BACKGROUND
In hospital medication errors are common. Our aim was to investigate risks of the analogue and digitally-supported medication process and any potential solutions.
METHODS METHODS
A mixed methods study including a structured literature search and online questionnaires based on the Delphi method was conducted. First, all risks were structured into main and sub-risks and second, risks were grouped into risk clusters. Third, healthcare experts assessed risk clusters regarding their likelihood of occurrence their possible impact on patient safety. Experts were also asked to estimate the potential for digital solutions and solutions that strengthen the competence of healthcare professionals.
RESULTS RESULTS
Overall, 160 main risks and 542 sub-risks were identified. Main risks were grouped into 43 risk clusters. 33 healthcare experts (56% female, 50% with >20 years professional-experience) ranked the likelihood of occurrence and the impact on patient safety in the top 15 risk clusters regarding the process steps: admission (n = 4), prescribing (n = 3), verifying (n = 1), preparing/dispensing (n = 3), administering (n = 1), discharge (n = 1), healthcare professional competence (n = 1), and patient adherence (n = 1). 28 healthcare experts (64% female, 43% with >20 years professional-experience) mostly suggested awareness building and training, strengthened networking, and involvement of pharmacists at point-of-care as likely solutions to strengthen healthcare professional competence. For digital solutions they primarily suggested a digital medication list, digital warning systems, barcode-technology, and digital support in integrated care.
CONCLUSIONS CONCLUSIONS
The medication process holds a multitude of potential risks, in both the analogue and the digital medication process. Different solutions to strengthen healthcare professional competence and in the area of digitalization were identified that could help increase patient safety and minimize possible errors.

Identifiants

pubmed: 38412194
doi: 10.1371/journal.pone.0297491
pii: PONE-D-23-20698
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0297491

Informations de copyright

Copyright: © 2024 Kopanz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Julia Kopanz (J)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Styria, Austria.

Katharina Lichtenegger (K)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Styria, Austria.

Christine Schwarz (C)

Department of Quality and Risk Management, University Hospital of Graz, Styria, Austria.
Department for Surgery, c/o Division for Plastic, Aesthetic and Reconstructive Surgery, Research Unit for Safety and Sustainability in Healthcare, Medical University of Graz, Styria, Austria.

Melanie Wimmer (M)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Styria, Austria.

Lars Peter Kamolz (LP)

Department for Surgery, c/o Division for Plastic, Aesthetic and Reconstructive Surgery, Research Unit for Safety and Sustainability in Healthcare, Medical University of Graz, Styria, Austria.

Thomas Pieber (T)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Styria, Austria.

Gerald Sendlhofer (G)

Department of Quality and Risk Management, University Hospital of Graz, Styria, Austria.
Department for Surgery, c/o Division for Plastic, Aesthetic and Reconstructive Surgery, Research Unit for Safety and Sustainability in Healthcare, Medical University of Graz, Styria, Austria.

Julia Mader (J)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Styria, Austria.

Magdalena Hoffmann (M)

Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Styria, Austria.
Department of Quality and Risk Management, University Hospital of Graz, Styria, Austria.
Department for Surgery, c/o Division for Plastic, Aesthetic and Reconstructive Surgery, Research Unit for Safety and Sustainability in Healthcare, Medical University of Graz, Styria, Austria.

Classifications MeSH