Medication safety and electronic decision support - news

Digital health systems are transforming care across healthcare sectors, but research shows they also create new hurdles for health professionals

In June 2023, Professor Johanna Westbrook presented research evidence at the ‘PCHSS Showcase: Future proofing healthcare’ conference. Outcomes from a study regarding the implementation of an electronic management system, showed although medication prescribing errors declined within the first year, errors increased within the first few months of implementation. To combat the potential frustrations and errors that can arise when implementing digital clinical information systems, Professor Westbrook and colleagues at AIHI launched the Health Innovation Series to outline practical, evidence-based recommendations. This research was reported by the Health Services Daily, found here.

Review Finds EHR Nudge Interventions Drive Care Quality Improvements

EHR Intelligence reports on the systematic review ‘Effectiveness of non-interruptive nudge interventions in electronic health records to improve the delivery of care in hospitals’. Led by Dr Magda Raban, the review evaluated five categories of nudge interventions: changing choice defaults; making information more visible; changing the range or composition of options; making information more or less salient; and changing option-related effort. Overall, 79.2 percent of EHR nudge interventions were successful in achieving improvements in care quality. Click here, to read the full article by EHR Intelligence.

eMM and medication administration errors under the spotlight

An article on PULSE+IT, reports the findings of a study, on the effects of an electronic medication system (EMS) on medication administration errors. Led by Professor Johanna Westbrook, the study found that adding an electronic medication management module to the clinical information system of a paediatric hospital did not reduce medication administration errors, with no changes in rates of errors in the first 70 days after the introduction of an EMS. To read more about this study, click here.

New funding for digital solution to medication reviews in aged care

Macquarie University has been awarded $1.5 million in the latest round of Medical Research Future Fund grants.

Dr Karla Seaman and Dr Magda Raban are leading the team to improve the safe use of medicines in residential aged care by creating a digital one-stop platform for faster and easier medication reviews by pharmacists. The platform will allow all stakeholders, including pharmacists, GPs, residents and their carers, and aged care staff, to monitor the medication review process. Read about the project here.

New grant will transform medication safety in aged care using IT innovation

Professor Johanna Westbrook has been awarded $992,386 from the National Health and Medical Research Council Medical Research Future Fund to lead a project to demonstrate how sophisticated and user-friendly IT systems can improve the management of medication and support staff and residents. Read about the project here.

Health Innovation Series

We are pleased to launch the new Health Innovation Series - evidence based recommendations to improve care delivery and outcomes.

With the new Health Innovation Series, we have synthesised five years of research evidence into highly practical tips for users (including nurses, doctors and pharmacists) and for system optimisation. Read each issue in less than 3 minutes and immediately think, how can you apply the evidence to your setting?

The Health Innovation Series recommendations are evidenced-based and each issue pinpoints a specific concern around medication safety, including electronic medication management systems.

National Medication Safety Symposium

The National Medication Safety Symposium was held on 21 September 2022 at Macquarie University.

The symposium presented an opportunity to engage with the latest evidence on how electronic systems support safer care, along with recommendations for improving system design and implementation processes.

Results from the Sydney Children’s Hospitals Network and eHealth NSW NHMRC partnership project on medication safety were presented.

To view the presentations, please visit the AIHI Youtube page.

Study results presented at the annual eMedication Management Conference

Dr Magda Raban presented the team’s work on technology-related errors at the annual eMedication Management Conference in Sydney in March 2022. Her presentation “Technology-related prescribing errors immediately and 1-year post-eMeds implementation at a paediatric hospital” detailed results generated from a Partnership Project with the Sydney Children’s Hospital Network and eHealth NSW.

New NHMRC Partnership Project on Medication Safety in Aged Care

Dr Magda Raban wins a conference award

Dr Magda Raban was the awarded the Elain Graham Robertson Award for best oral abstract at the Australasian College for Infection Prevention and Control conference in November 2021. Dr Raban presented her work on “Reducing antibiotic prescribing using nudges: a systematic review of interventions in primary care”.

Evidence Briefings on Interventions to Improve Medication Safety

The team was engaged by the Australian Commission for Safety and Quality in Health Care (the Commission) to provide evidence briefing on six key medication safety interventions in hospitals:

• Electronic prescribing systems
• Electronic medication administration records
• Scanning medication administration systems
• Closed-loop medication management systems
• Double-checking medication administration
• Reducing interruptions during medication prescribing, preparation and administration

Literature reviews were conducted and the evidence on each of the interventions summarised for the Australian context. The briefings are available here.

Survey invitation - services for children in hospital

If your child were in hospital, what care and services would be most important to you?

If you are a parent of a child under 18 years, we’d love to hear from you and invite you to complete this survey. Please also share the link or pdf with family, friends (school class parent groups for instance) and colleagues.

We are working with Sydney Children’s Hospital Network to improve care for children in hospital as part of our NHMRC Partnership Project. The survey takes about 10 minutes to complete.

If you have any questions, please contact Dr Virginia Mumford - virginia.mumford@mq.edu.au

SURVEY

Antibiotic use is higher in Australia’s residential aged care facilities than in other countries

Dr Magda Raban is interviewed by Aged Care Insite on our recent research comparing the use of antibiotics in residential aged care facilities internationally,  Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis.

To read the article, please visit Aged Care Insite

Transforming medication management in residential aged care with digital systems

In the November issue of The Health Advocate, Dr Magda Raban and Prof Johanna Westbrook discuss the challenges and opportunities for electronic medication systems in residential aged care, and the key role they can play in aged care reform.

Erin Fitzpatrick and Alison Merchant receive the Centre's Professional Excellence Award for 2020

At the last AIHI meeting for 2020, Erin Fitzpatrick's and Alison Merchant's contributions to and leadership in work on medication errors and electronic system related errors were recognised. Erin and Alison were joint awardees of the Professional Excellence Award in the Centre for Health Systems and Safety Research for the year. Erin and Alison have been applying their expertise in clinical pharmacy to a large NHMRC funded Partnership Project with the Sydney Children's Hospital Network examining the impact of electronic medication management systems on medication errors and patient harm.

Professor Johanna Westbrook awarded the National Health and Medical Research Council (NHMRC) Elizabeth Blackburn Investigator Grant Award

The outstanding leadership of Macquarie University Professor Johanna Westbrook has been recognised with the announcement of the National Health and Medical Research Council (NHMRC) Elizabeth Blackburn Investigator Grant Award (Leadership in Health Services Research) at the NHMRC Research Excellence Awards in Canberra last night.

Professor Westbrook is internationally recognised for her research evaluating the effects of information and communication technology in healthcare and is the Director of the Centre for Health Systems and Safety Research at the Australian Institute of Health Innovation.

The Elizabeth Blackburn Investigator Grant Award recognises the highest-ranking woman in the area of health services, determined by a peer review process. Read more.

Drop in medication errors at children’s hospital with new e-system

Early results from the Delivering safe and effective care for children project have recently gained media attention. Prof Johanna Westbrook provides background here and here .

30^th Medical Informatics Europe (MIE) conference, 2020

Dr Valentina Lichtner’s submissions to 30th Medical Informatics Europe conference (MIE) have been accepted. Valentina will present in Geneva, 28/4-1/5/2020.

• A poster: Lichtner, V, Prgomet, M, Franklin, BD, Westbrook, JI, The ‘back office’ of a dispensing cabinet: technology and work contributing to medication safety
• A workshop: Lichtner, V, Pelayo, S, Westbrook, JI, Drifting into medication errors with automated dispensing cabinets: how to prevent it? A workshop for a medical informatics approach
• A workshop: Marcilly, R, Kuziemsky, C,  Nohr, C, Peute, L, Lichtner, V, Ethics Reviews and Human and Organizational Factors’ Research in European Countries: a panel from the HOFMI working group

Prof Johanna  Westbrook awarded $2.5M of NHMRC funding for research on optimising eMM

Prof Johanna Westbrook was awarded a National Health and Medical Research Council Investigator Grant worth $2.5 million titled “Delivering safe and effective medication management technology now and for the future”.

There is little robust evidence to guide massive investments in electronic medication management (eMM) systems in hospitals. This innovative program of work will generate the new evidence, policy and practice urgently needed to optimise eMM systems to ensure they save lives and improve health outcomes, now and in future.

Dr Valentina Lichtner presents an AIHI Seminar, 10 October 2019

Dr Valentina Lichtner presented her work on “Ultra-safe, collective mindfulness and electronic medication management systems in paediatric oncology” at the AIHI Seminar Series, Macquarie University. Dr Lichtner’s presentation discussed the challenges of operating ultra-safe models of safety; how adherence to protocol and management of risks is sometimes achieved through collective mindfulness practices typical of high-reliability organisations; and the three levels of awareness (situation, team and organisational) that make technology work.

Dr Lichtner is a Marie-Curie visiting fellow at the Centre for Health Systems and Safety Research where she has been working with the Medication Safety and Decision Support team.

36^th International Society for Quality in Health Care International Conference, Cape Town, 20-23 October, 2019

Prof Johanna Westbrook, Dr Peter Gates and Dr Kim Lind represented the Medication Safety and Electronic Decision Support team at the ISQua International Conference in Capetown in October 2019. They delivered five presentations and posters. Read more.