Investigation Interoperability Problems in Pharmacy Automation: A Case Study in Saudi Arabia

The aim of this case study is to investigate the nature of interoperability problems in hospital systems automation. One of the advanced healthcare providers in Saudi Arabia is the host of the study. The interaction between the pharmacy system and automated medication dispensing cabinets is the focus of the case system. The research method is a detailed case study where multiple data collection methods are used. The modelling of the processes of inpatient pharmacy systems is presented using Business Process Model Notation. The data collected is analysed to study the different interoperability problems. This paper presents a framework that classifies health informatics interoperability implementation problems into technical, semantic, organisational levels. The detailed study of the interoperability problems in this case illustrates the challenges to the adoption of health information system automation which could help other healthcare organisations in their system automation projects

Healthcare professionals' perceptions of the facilitators and barriers to implementing electronic systems for the prescribing, dispensing and administration of medicines in hospitals: a systematic review.

Abstract Objective To identify, critically appraise, synthesise and present the available evidence on healthcare professionals' perceptions of the facilitators and barriers to implementing electronic prescribing, dispensing and/or administration of medicines in the hospital setting. Methods A systematic search of studies focusing on healthcare professionals' perceptions of technologies for prescribing, dispensing and administering medicines in the hospital setting was performed using MEDLINE, Cumulative Index to Nursing and Allied Health, International Pharmaceutical Abstracts, PsycARTICLES, PsycINFO, Cochrane Database of Systematic Reviews and Centre for Reviews and Dissemination. Grey literature inclusive of manual searching of core journals, relevant conference abstracts and online theses were also searched. Independent duplicate screening of titles, abstracts and full texts was performed by the authors. Data extraction and quality assessment were undertaken using standardised tools, followed by narrative synthesis. Key findings Five papers were included in the systematic review after screening 2566 titles. Reasons for exclusion were duplicate publication; non-hospital setting; a lack of investigation of healthcare professionals' perceptions and a lack of focus on implementation processes or systems specific to electronic prescribing, dispensing or administration of medicines. Studies were conducted in the USA, Sweden and Australia. All studies used qualitative interview methods. Healthcare professionals perceived systems improved patient safety and provided better access to patients' drug histories and that team leadership and equipment availability and reliability were essential for successful implementation. Key barriers included hardware and network problems; altered work practices such as time pressure on using the system and remote ordering as a potential risk for errors; and weakened interpersonal communication between healthcare professionals and with patients. Conclusions Few studies were identified on healthcare professionals' perceptions of the facilitators and barriers to system implementation in hospitals. Key facilitators included a perception of increased patient safety and better access to patients' drug history while key barriers involved technical problems, changes to routine work practices and weakened interpersonal communication. Investigating this area further will assist in improving patient safety and reducing medication costs by informing and strengthening implementation strategies

Exploring the facilitators and barriers towards implementation of electronic prescribing, dispensing, and administration of medicines in hospitals in Ireland.

Limited data exist on the facilitators and barriers to implementing electronic systems for medicines management in hospitals. Whilst numerous studies advocate system use in improved patient safety and efficiency within the health service, their rate of adoption in practice has been slow. The aim of this doctoral research was to explore this under-researched area in three phases. Phase one: - Phase one focused on critically appraising and synthesising the available evidence on healthcare professionals perceptions, attitudes, and views of the facilitators and barriers to implementing electronic prescribing, electronic dispensing, and/or electronic administration of medicines in the hospital setting. The review protocol was registered with the Centre for Reviews and Dissemination and conducted according to best practice. Key facilitators included systems improved patient safety and provided better access to patients drug records and that team leadership and hardware/software availability and reliability were essential for successful implementation. Key barriers consisted of hardware and network problems, altered work practices, and weakened interpersonal communication between healthcare professionals and with patients. Phase two: - This phase employed a qualitative phenomenological design to gain original insight into the perceptions of local key stakeholders towards the facilitators and barriers to implementing prescribing, robotic pharmacy systems, and automated medication storage and retrieval systems in public hospitals in Ireland using Normalization Process Theory as a theoretical framework. Individual face-to-face semi-structured interviews were conducted in three public hospitals in Ireland with 23 consenting participants: nine nurses; four pharmacists; two pharmacy technicians; six doctors; and two hospital Information Technology managers. Enhanced patient safety and efficiency in healthcare delivery emerged as key facilitators to system implementation, as well as the need to have clinical champions and a multidisciplinary implementation team to promote engagement and cognitive participation. Key barriers included inadequate training and organisational support, and the need for ease and confidence in system use to achieve collective action. Phase three: - A similar qualitative methodology was employed in phase three of this research in order to explore the perceptions of national key stakeholders and eHealth leads towards the facilitators and barriers to system implementation. Sixteen consenting invitees participated: eight hospital leads, four government leads, two regulatory leads, and two academics. Key facilitators included enhanced patient safety, workflow efficiencies, improvements in governance, and financial gains. Perceived barriers included the introduction of new drug errors, loss of patient contact, initial time inefficiencies, and issues with the complexity of integration and standardisation of work processes. Overall, adequate technology, stakeholder involvement, and organisational leadership and support are required at a national and local level to drive the eHealth agenda forward. Testing at scale, contingency plans, and ongoing evaluations will assist in determining success or otherwise of system implementation. This research has generated novel findings with many potentially transferable themes identified which extend the evidence base. This will assist organisations to better plan for implementation of medication-related eHealth systems

Implementing medicines New Zealand 2015 to 2020

Summary Medicines play a significant role in helping New Zealanders get well, stay well and live well. We have already made positive changes in this area, but there are substantial challenges ahead of us. We need to buy, use and manage medicines wisely. We need to meet the needs of our ageing population and meet the needs of the increasing numbers of people with multiple chronic conditions. And we need to meet these needs in a way that is more efficient, more coordinated and achieves the most from our limited health dollars. Medicines New Zealand (the New Zealand medicines strategy) provides the overarching framework to govern the regulation, procurement, management and use of medicines in New Zealand. The three core outcomes for the medicines system as set out in the Strategy are: access optimal use quality, safety and efficacy. Implementing Medicines New Zealand is about the changes required to deliver on Medicines New Zealand. This action plan supports the achievement of the Strategy’s outcomes by: making the most of every point of care enabling shared care through an integrated health care team optimal use of antimicrobials empowering individuals and families/whānau to manage their own medicines and health optimal medicines use in older people and those with long-term conditions competent and responsive prescribers removing barriers to access. This will be done by harnessing the collective efforts of all health professionals, including those working in community organisations, primary health care, pharmacies, hospitals, rest homes and end-of-life care

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations

Reviewing the Drivers and Challenges in RFID Implementation in the Pharmaceutical Supply Chain

Counterfeiting is a global phenomenon that poses a serious financial threat to the pharmaceutical industry and more importantly jeopardizes public safety and security. Different measures, including new laws and regulations, have been put in place to mitigate the threat and tighten control in the pharmaceuticals supply chain. However, it appears that the most promising countermeasure is track-and-trace technology such as electronic-pedigree (E-pedigree) with Radio Frequency Identification (RFID) technology. In this study we present a framework exploring the antecedents and consequences of RFID applications in the pharmaceutical supply chain. The framework proposes that counterfeiting and E-pedigree regulation will drive the implementation of RFID in the pharmaceutical supply chain, which in turn provides strategic and operational benefits that enable competitive advantage. Meanwhile, the implementation of RFID requires overcoming many operational, technical and financial challenges. The framework provides a springboard that future study can explore using empirical data

Effects of Enterprise Digital Assistants in medication dispensing operations: Case hospital pharmacy

OBJECTIVES OF THE STUDY In this thesis, I study the effects of introducing automation in the form of barcode-reader enabled Enterprise Digital Assistants and their impact on work efficiency and medication safety in a hospital pharmacy setting. The goal is to determine whether the efficiency of the process can be improved without compromising medication safety. In addition to the quantitative objectives, employee perceptions on the likelihood of success of the implementation are studied to include a more qualitative approach on the subject. DATA AND METHODOLOGY The data include information on different phases of the medication dispensing process taking place in the HUS Hospital Pharmacy in Helsinki, Finland. My sample consists of 80 341 orders processed on 143 days between July 2014 and April 2015. I use statistical analysis to calculate pre- and post-implementation process throughput times and error rates. Employee perceptions are measured with a questionnaire and interviews. FINDINGS OF THE STUDY It is possible to improve the efficiency of the order-picking process by automating the pharmaceutical inspection phase with the EDAs without increasing the dispensing error rate. Firstly, The efficiency of the order-picking process improved by 34% from 1.40 rows per minute to 1.87 rows per minute. Secondly, the EDA implementation bears potential for further process streamlining, as the pharmaceutical inspection could be performed without an additional hospital pharmacist, freeing resources to perform more knowledge-intensive work tasks. The questionnaire and employee interviews revealed that employee perceptions on the usefulness and the ease-of-use of the implementation would seem to affect positively on the perceived likelihood of success of the implementation. Even though the implementation project had faced several difficulties, the employees considered that the devices are useful and thus have faith in the success of the implementation

Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access

Closed loop medication administration using mobile nursing information system

Through this long journey of PhD study including a research on ‘Closed Loop Medication Administration Using Mobile Nursing Information System’ and the thesis writing, I obtained a lot of knowledge and experience about research method and writing. I really very appreciate the help of all my supervisors