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Qualitative evaluation of an electronic prescribing and administration system.

Barber, N; Cornford, T; Klecun, E; (2007) Qualitative evaluation of an electronic prescribing and administration system. Qual Saf Health Care , 16 (4) 271 - 278. 10.1136/qshc.2006.019505. Green open access

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Abstract

Objective: To provide a formative socio-technical evaluation of a pilot implementation of an integrated electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on one ward. Design: A qualitative observational approach using discourse analysis within a socio-technical evaluation framework addressing systems functions, human perspectives and organisational context. Setting: Surgical ward in a teaching hospital. Participants: Staff on study ward and in pharmacy. Intervention: Implementation over time of an integrated electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures: Assessment of technical performance, developed attitudes to the new system, changes to delivery of care and work practices. Results: The system was successfully implemented on the ward, and remained in operation for over 2 years. Many of the technical components of the system initially showed problems, but the system evolved, with increased functionality and improved performance. Attitudes to the system in the early stages were mixed. Over time, and with experience of making the system work for them, staff attitudes changed to become more balanced and the potential benefits of the system became clearer to most. The system structured the work of staff, sometimes unexpectedly. Conclusions: Electronic prescribing systems need to be seen as occasions for change and learning rather than as black-boxed technical solutions to identified problems. The evaluation framework allows understanding as well as hypothesis testing, and is recommended for future evaluations of electronic prescribing systems.

Type: Article
Title: Qualitative evaluation of an electronic prescribing and administration system.
Location: England
Identifier: PMCID: PMC2464937
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/qshc.2006.019505
Publisher version: http://dx.doi.org/10.1136/qshc.2006.019505
Language: English
Additional information: This paper is freely available online under the BMJ Journals unlocked scheme, see: http://qshc.bmj.com/info/unlocked.dtl
Keywords: Attitude of Health Personnel, Attitude to Computers, Clinical Pharmacy Information Systems, Hospital Units, Hospitals, Teaching, Humans, Learning, London, Medical Order Entry Systems, Organizational Innovation, Patient Identification Systems, Pilot Projects, Point-of-Care Systems, Systems Integration
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/1351529
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