Electronic Medication Management Systems: Analysis of Enhancements to Reduce Errors and Improve Workflow

2021 ◽  
Vol 12 (05) ◽  
pp. 1049-1060
Author(s):  
Madaline Kinlay ◽  
Lai Mun Rebecca Ho ◽  
Wu Yi Zheng ◽  
Rosemary Burke ◽  
Ilona Juraskova ◽  
...  
Keyword(s):  
Medication Errors ◽  
Systems Analysis ◽  
Continuous Monitoring ◽  
Medication Management ◽  
Electronic System ◽  
Management Systems ◽  
Safety Risks ◽  
System Use ◽  
Changes Over Time ◽  
Over Time

Abstract Background Electronic medication management (eMM) has been shown to reduce medication errors; however, new safety risks have also been introduced that are associated with system use. No research has specifically examined the changes made to eMM systems to mitigate these risks. Objectives To (1) identify system-related medication errors or workflow blocks that were the target of eMM system updates, including the types of medications involved, and (2) describe and classify the system enhancements made to target these risks. Methods In this retrospective qualitative study, documents detailing updates made from November 2014 to December 2019 to an eMM system were reviewed. Medication-related updates were classified according to “rationale for changes” and “changes made to the system.” Results One hundred and seventeen updates, totaling 147 individual changes, were made to the eMM system over the 4-year period. The most frequent reasons for changes being made to the eMM were to prevent medication errors (24% of reasons), optimize workflow (22%), and support “work as done” on paper (16%). The most frequent changes made to the eMM were options added to lists (14% of all changes), extra information made available on the screen (8%), and the wording or phrasing of text modified (8%). Approximately a third of the updates (37%) related to high-risk medications. The reasons for system changes appeared to vary over time, as eMM functionality and use expanded. Conclusion To our knowledge, this is the first study to systematically review and categorize system updates made to overcome new safety risks associated with eMM use. Optimization of eMM is an ongoing process, which changes over time as users become more familiar with the system and use is expanded to more sites. Continuous monitoring of the system is necessary to detect areas for improvement and capitalize on the benefits an electronic system can provide.

scholarly journals Review of medication errors that are new or likely to occur more frequently with electronic medication management systems

2019 ◽  
Vol 43 (3) ◽  
pp. 276 ◽  
Author(s):  
Melita Van de Vreede ◽  
Anne McGrath ◽  
Jan de Clifford
Keyword(s):  
Medication Error ◽  
Medication Errors ◽  
Classification System ◽  
Medication Management ◽  
Management Systems ◽  
Prescribing Errors ◽  
New Classification ◽  
Severity Rating ◽  
Retrospective Audit ◽  
Error Types

Objective The aim of the present study was to identify and quantify medication errors reportedly related to electronic medication management systems (eMMS) and those considered likely to occur more frequently with eMMS. This included developing a new classification system relevant to eMMS errors. Methods Eight Victorian hospitals with eMMS participated in a retrospective audit of reported medication incidents from their incident reporting databases between May and July 2014. Site-appointed project officers submitted deidentified incidents they deemed new or likely to occur more frequently due to eMMS, together with the Incident Severity Rating (ISR). The authors reviewed and classified incidents. Results There were 5826 medication-related incidents reported. In total, 93 (47 prescribing errors, 46 administration errors) were identified as new or potentially related to eMMS. Only one ISR2 (moderate) and no ISR1 (severe or death) errors were reported, so harm to patients in this 3-month period was minimal. The most commonly reported error types were ‘human factors’ and ‘unfamiliarity or training’ (70%) and ‘cross-encounter or hybrid system errors’ (22%). Conclusions Although the results suggest that the errors reported were of low severity, organisations must remain vigilant to the risk of new errors and avoid the assumption that eMMS is the panacea to all medication error issues. What is known about the topic? eMMS have been shown to reduce some types of medication errors, but it has been reported that some new medication errors have been identified and some are likely to occur more frequently with eMMS. There are few published Australian studies that have reported on medication error types that are likely to occur more frequently with eMMS in more than one organisation and that include administration and prescribing errors. What does this paper add? This paper includes a new simple classification system for eMMS that is useful and outlines the most commonly reported incident types and can inform organisations and vendors on possible eMMS improvements. The paper suggests a new classification system for eMMS medication errors. What are the implications for practitioners? The results of the present study will highlight to organisations the need for ongoing review of system design, refinement of workflow issues, staff education and training and reporting and monitoring of errors.

scholarly journals Nonparametric tests for stationary analysis in hydrological data

2019 ◽  
pp. 239-250 ◽  
Author(s):  
Uilson Ricardo Venâncio Aires ◽  
Guilherme Barbosa Reis ◽  
Jasmine Alves Campos
Keyword(s):  
Land Use ◽  
Anthropogenic Activities ◽  
Nonparametric Tests ◽  
Management Systems ◽  
Hydrological Data ◽  
Stationary Analysis ◽  
Streamflow Data ◽  
Changes Over Time ◽  
Over Time ◽  
Land Use And Cover

One of the main problems for water resources management systems has been the climate change and the intensification of anthropogenic activities in river basins. In this context, this work aimed to analyze the dynamics of land use and cover and its influence on temporal variability on streamflow data. The behavior of hydrological data (streamflow and rainfall) over time was analyzed by applying the nonparametric tests of Mann Kendall and Pettitt. Images derived from orbital sensors using the Random Forest classifier assessed the anthropogenic influence in the area, land use, and cover classification. The rainfall data did not present significant changes over time, according to the applied tests. However, the low annual flow and average annual flow presented nonstationary behavior, with a trend of reduction over time. As rainfall did not change in its patterns over time, the main reason associated with the changes in streamflow regimes was associated with the changes in land use and land cover, especially in the areas for crops, that had an increase of 48% in the study period, which can contribute to increase the demand for water and affect the streamflow. The results obtained confirm the importance of this study for water management systems to adapt itself to the changes in hydrological behavior over time.

scholarly journals Challenges of Quantifying PRISM 2.0 and Tablet Use

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 308-308
Author(s):  
Neil Charness ◽  
Jerad Moxley ◽  
Walter Boot
Keyword(s):  
Systems Analysis ◽  
Easy Task ◽  
Important Measure ◽  
Frequent Use ◽  
Patterns Of Use ◽  
System Use ◽  
System Success ◽  
Over Time

Abstract As with the PRISM 1.0 trial, an important outcome of the PRISM 2.0 trial is use of the PRISM system and use of the PRISM system compared to the control condition (a standard tablet without the PRISM software). Frequent use over time is an important measure of system success. Further, use data provide key measures of system usefulness and usability. What features do participants use most and how often? Within those features, what activities do they engage in? What are the patterns of use throughout the trial, and how does PRISM system use compare to the control condition? However, quantifying use is not an easy task. This talk presents the challenges of quantifying use of a complex, multi-faceted system, and of making meaningful comparisons in use between two very different systems. Analysis approaches and solutions are discussed.

Comparison of two devices for measuring exercise transcutaneous oxygen pressures in patients with claudication

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 355-362 ◽  
Author(s):  
Marie Urban ◽  
Alban Fouasson-Chailloux ◽  
Isabelle Signolet ◽  
Christophe Colas Ribas ◽  
Mathieu Feuilloy ◽  
...  
Keyword(s):  
Oxygen Pressure ◽  
Optical Sensors ◽  
Chemical Sensors ◽  
Transcutaneous Oxygen ◽  
Starting Values ◽  
Two Systems ◽  
Transcutaneous Oxygen Pressure ◽  
New Sensors ◽  
Changes Over Time ◽  
Over Time

Abstract. Summary: Background: We aimed at estimating the agreement between the Medicap® (photo-optical) and Radiometer® (electro-chemical) sensors during exercise transcutaneous oxygen pressure (tcpO2) tests. Our hypothesis was that although absolute starting values (tcpO2rest: mean over 2 minutes) might be different, tcpO2-changes over time and the minimal value of the decrease from rest of oxygen pressure (DROPmin) results at exercise shall be concordant between the two systems. Patients and methods: Forty seven patients with arterial claudication (65 + / - 7 years) performed a treadmill test with 5 probes each of the electro-chemical and photo-optical devices simultaneously, one of each system on the chest, on each buttock and on each calf. Results: Seventeen Medicap® probes disconnected during the tests. tcpO2rest and DROPmin values were higher with Medicap® than with Radiometer®, by 13.7 + / - 17.1 mm Hg and 3.4 + / - 11.7 mm Hg, respectively. Despite the differences in absolute starting values, changes over time were similar between the two systems. The concordance between the two systems was approximately 70 % for classification of test results from DROPmin. Conclusions: Photo-optical sensors are promising alternatives to electro-chemical sensors for exercise oximetry, provided that miniaturisation and weight reduction of the new sensors are possible.

Neuropsychological Symptoms in Posttraumatic Stress Disorder and Changes Over Time

2007 ◽  
Author(s):  
Miranda Olff ◽  
Mirjam Nijdam ◽  
Kristin Samuelson ◽  
Julia Golier ◽  
Mariel Meewisse ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Neuropsychological Symptoms ◽  
Changes Over Time ◽  
Over Time

Changes Over Time in Adaptive Behavior Functioning of Twice-Exceptional Children

2010 ◽  
Author(s):  
Rebecca D. Stinson ◽  
Zachary Sussman ◽  
Megan Foley Nicpon ◽  
Allison L. Allmon ◽  
Courtney Cornick ◽  
...  
Keyword(s):  
Adaptive Behavior ◽  
Exceptional Children ◽  
Twice Exceptional ◽  
Changes Over Time ◽  
Over Time

Kategorisierung der Schädelform des Cavalier King Charles Spaniels

2019 ◽  
Vol 47 (02) ◽  
pp. 133-133
Keyword(s):  
Pilot Study ◽  
Cavalier King Charles Spaniel ◽  
Conformation Changes ◽  
Veterinary Record ◽  
Changes Over Time ◽  
Over Time

Knowler SP, Gillstedt L, Mitchell TJ et al. Pilot study of head conformation changes over time in the Cavalier King Charles spaniel breed. Veterinary Record 2019. doi:10.1136/vr.105135.

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