The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist's time and activities
- 1 June 2007
- journal article
- Published by Oxford University Press (OUP) in International Journal of Pharmacy Practice
- Vol. 15 (2), 133-139
- https://doi.org/10.1211/ijpp.15.2.0009
Abstract
Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with ‘self’. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.Keywords
This publication has 9 references indexed in Scilit:
- Qualitative evaluation of an electronic prescribing and administration systemQuality and Safety in Health Care, 2007
- The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after studyQuality and Safety in Health Care, 2007
- Information technology and medication safety: what is the benefit?Quality and Safety in Health Care, 2002
- Using information technology to reduce rates of medication errors in hospitalsBMJ, 2000
- Drug-Related Problems in Hospitalised PatientsDrug Safety, 2000
- Pharmacy research: the place of work measurementInternational Journal of Pharmacy Practice, 1998
- Work activities before and after implementation of an automated dispensing systemAmerican Journal of Health-System Pharmacy, 1996
- Ward pharmacy services — is a once daily visit less efficient than a twice daily visit?International Journal of Pharmacy Practice, 1995
- How do ward pharmacists spend their time?: An activity sampling studyInternational Journal of Pharmacy Practice, 1992