319 research outputs found

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

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    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

    A model on factors affecting nurses adoption of health information technology

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    Healthcare organisations are using Health Information Technology (HIT) to improve efficiency, reduce cost and reduce medical errors. This study focused on the factors that influence the acceptance of HIT among nurses in Saudi hospitals. This research used a 6 stage mixed-methods research approach. Literature was used to search for established models and frameworks of technology acceptance, and the many factors that could play a role. In the field study, the nature of practical HIT issues at the Prince Sultan Military Medical City (PSMMC) and the Heraa Hospital were studied, and combined with literature to create a HIT Implementation Issues Framework. The framework consolidates elements from the Technological, Organisational, Environmental and Human dimensions. The researcher participated in further PSMMC projects in the design and implementation of the new Cardio Pulmonary Resuscitation System and the Nurses and Pharmacists’ Communication System. From the implementation experience, pertinent factors were added to the Technology Acceptance Model and the “Nurses Acceptance Model” was proposed. The proposed model has eleven independent parameters, two dependent parameters, as well as seven moderators of key relationships. A questionnaire with 71 entries was distributed to over 2800 nurses in 52 wards in PSMMC. SPSS was used for data screening and descriptive statistics. The SmartPLS software was used for analysis and testing of the proposed hypotheses. The findings refined the “Nurses Acceptance Model” and highlight the significance of User Involvement and Training. The “Nurses Acceptance Model” enhances the scientific understanding of variables that affect technology acceptance among nurses in Saudi hospitals. The HIT Implementation Issues Framework helps hospital decision makers to plan HIT projects to improve the likelihood of successful adoption

    Systematic review on the effects of the physical and social aspects of community pharmacy spaces on service users and staff

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    AIM: This systematic review aimed to provide new insights into how pharmacy spaces, or the architecture of pharmacies, are experienced by pharmacy service users and staff. The review sought to identify environmental factors which may influence service users' and staff participation in community-based pharmacy health services. METHOD: Ten databases were searched for English language publications, using a combination of search terms relating to pharmacy service users and staff; pharmacy spaces; and health and social care outcomes. Data from the final selected studies were extracted, thematically analysed using a narrative approach and the quality of each study assessed using the Integrated quality Criteria for the Review of Multiple Study designs (ICROMS). RESULTS: 80 articles reporting 80 studies published between 1994 and 2020 were identified; they were from 28 countries, involving around 3234 community pharmacies, 13,615 pharmacy service users, 5056 pharmacists and 78 pharmacy health staff. Most studies (94%) met the ICROMS minimum score, and half did not meet the mandatory quality criteria. Four themes likely to influence service users' and staff experiences of pharmacy health services were identified: (1) privacy; (2) experience of the physical environment; (3) professional image; and (4) risk of error. CONCLUSION: To optimise the delivery and experience of pharmacy health services, these spaces should be made more engaging. Future applied research could focus on optimising inclusive pharmacy design features

    Pharmacies and medication information system in Jeddah City, Saudi Arabia

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    It is acknowledged that the introduction of Health Information Systems (HIS) have contributed to the reorganization of the methods used in health services for Health Information Management. Managers in the health services benefit from Health Information Systems provision both strategically and operationally, for example in the planning of new services and more routinely in assisting health professionals in making informed medical decisions. Health services in developed countries already have Health Information Systems (HIS) in place but their adoption in developing countries has been less widespread. In Jeddah, KSA there is a lack of a unified HIS. Health service provision in Jeddah is spread between a wide range of governmental and private health services. The lack of unification of these services and a bespoke HIS has led to problems for both patients and healthcare professionals. This research focuses on the methods of prescribing medication, provision of supplies and the dispensing of medication within pharmacies. [Continues.

    Types and Contributing Factors of Dispensing Errors in Hospital Pharmacies

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    Background: Dispensing medication is a chain of multiple stages, and any error during the dispensing process may cause potential or actual risk for the patient. Few research studies have investigated the nature and contributory factors associated with dispensing errors in hospital pharmacies. Aim: To determine the nature and severity of dispensing errors reported in the hospital pharmacies at King Saud Medical City (KSMC) hospital in Saudi Arabia, and at Luton and Dunstable University Hospital (L&D) NHS Foundation Trust in the UK; and to explore the pharmacy staff perceptions of contributory factors to dispensing errors and strategies to reduce these errors. Materials and Methods: A mixed method approach was used and encompassed two phases. Phase I: A retrospective review of dispensing error reports for an 18-month period at the two hospitals. The potential clinical significance of unprevented dispensing errors was assessed. Data was analysed using descriptive statistics in SPSS and A Fisher’s test was used to compare the findings. Phase II: Self-administered qualitative questionnaires (open-ended questions) were distributed to the dispensary teams in KSMC and L&D hospitals. Content analysis was applied to the qualitative data using NVivo qualitative analysis software. Result: Dispensing the wrong medicine or the incorrect strength were the most common dispensing error types in both hospitals. Labelling errors were also common at the L&D pharmacy dispensary. The majority of the unprevented dispensing errors were assessed to have minor or moderate potential harm to patients. Look-alike/sound-alike medicines, high workload, lack of staff experience, fatigue and loss of concentration during work, hurrying through tasks and distraction in the dispensary were the most common contributory factors suggested. Ambiguity of the prescriptions was a specified factor in the L&D pharmacy, while poor pharmacy design and unstructured dispensing process were specified contributory factors in the KSMC pharmacy. Conclusions: Decreasing distractions and enhancing the pharmacy design and the dispensing workflow are necessary to reduce dispensing errors. Furthermore, monitoring and reporting errors and educating the dispensary team about these errors is also needed. Automation and e-prescribing systems may improve dispensing efficiency and safety. The findings of this study reemphasise the fact that dispensing errors are prevalent in hospital pharmacies. Efficient interventions need to be implemented to mitigate these errors

    Impact of a large-scale robotics adoption on the hospital pharmacy workforce

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    The National Health Service (NHS) regularly adopts new technologies which often result in the redesign of services, where large numbers of staff undergo organisational change. The NHS is made up of teams of people, all of whom continue to work interdependently providing safe and effective care throughout these times of change. Automation in pharmacy is becoming popular, with recent advancements involving the automation of the medicines supply chain. Previous ventures involving Automated Dispensing Systems (ADS) have been small-scale. Maximising efficiencies through automation relies on the effective introduction of technologies as well as the alignment of technical and social change, and there has been little exploration of how automation impacts on the staff experience and team effectiveness. In the literature there are numerous models available against which to compare and analyse the success of teams more generally. Underpinning many of these models is the Hackman model which proposes that team effectiveness is influenced by: the effort team members exhibit; the knowledge and skills team members possess; and the appropriateness of the performance strategies implemented. There is a gap in the literature on the impacts large-scale automation has on teams (and their success) in healthcare, specifically in pharmacy. Approved in August 2008, NHS Greater Glasgow & Clyde (GG&C) initiated a large-scale redesign (the PPSU Acute Pharmacy Redesign Programme). The Programme aimed to; provide a single procurement department for Glasgow pharmacy; have a centralised Pharmacy Distribution Centre (PDC); introduce ward-level ordering; and improve the current staff skill-mix while promoting the use of patients’ own medicines in hospital (Making the Most of Your Medicines or MMyM). Since opening in September 2010, the PDC (comprising 9 robots in total) is now the single facility responsible for the procurement and distribution of medicines to approximately 4000 destinations, and affected approximately 530 hospital pharmacy staff. This scale of pharmacy redesign has not been seen in any other automated schemes in the UK. The aim of the first study was to describe and evaluate NHS GG&C pharmacy staff experiences over the programme duration by different job roles/locations. Interviews were conducted with 36 pharmacy staff members from 4 hospital sites and the PDC, and 9 stakeholders, identified by members of the project Steering Group. Staff were interviewed about their experiences before, during and after the redesign. An inductive content analysis was performed, which produced two main themes: “The Work I Do” and “The Context of My Work”. The first theme allowed the exploration of the changes in staff job role, with a focus on tasks, work pace/control, morale, training/progression opportunities and voice/relationships. The second theme focused on social impacts of the redesign, including support, leadership, praise, reliability and trust of co-workers. Results showed that there was a lack of training available and morale was low in part due to this. There was no cohesive vision among participants as to why the redesign was happening. Hospital staff training was in theory available, yet completing training, and progressing into higher pay bands was not always feasible. Management were concerned with PDC technicians losing their clinical-skills as a result of a change in job location. PDC support workers experienced a gradual depletion of medicines knowledge due to this transition. The pharmacist role was seen as more social. Experiences between MMyM and non-MMyM staff were different in terms of how challenging, varied and social the work was. All roles within the PDC appeared to be less social compared with hospital roles. The aims of the second study were to apply Hackman’s model of team effectiveness in the context of the pharmacy team dynamics and performance and (based on this model) discuss the extent to which these teams were successful in the adoption of the automation. Hackman’s characteristics were applied to the pharmacy staff interviews (n=36). The results indicated that PDC and hospital teams exhibited 8 of the 23 characteristics: members have a variety of high-level skills; members contribute and are motivated equally; members are equally committed; members have personal and professional skills; relevant education and training is present; learning should be collective; members self-regulate; and there is clarity about task requirements, constraints, resources available and who the service user is. The “minimising of performance slippages” characteristic could be observed in one hospital team but not in the PDC. The teams did not exhibit 5 of the characteristics, indicating less success in these areas: autonomy is available; adequate feedback is available; excellent performance is rewarded; team size is appropriate; and relevant education and training is actually available. Nine of Hackman’s characteristics could not be commented on due to a lack of illustrative data. This thesis adds to the limited literature on the exploration of automation in healthcare, specifically pharmacy. Three main lessons can be concluded: staff consultation and engagement is critical to the successful redesign of services driven by technology; ensuring job role components are appropriate for job tasks is essential- technology adoption may require new skill sets and also cause other pre-existing skill sets to become lost; team effectiveness is an important focus within any organisational change programme, but less up-to-date models of team effectiveness may not be ideally applicable to teams utilising technology. These lessons align with current Scottish Government policy on pharmacy innovation and provide valuable key points for change implementers to support the continued adoption of automation locally, nationally and internationally.The National Health Service (NHS) regularly adopts new technologies which often result in the redesign of services, where large numbers of staff undergo organisational change. The NHS is made up of teams of people, all of whom continue to work interdependently providing safe and effective care throughout these times of change. Automation in pharmacy is becoming popular, with recent advancements involving the automation of the medicines supply chain. Previous ventures involving Automated Dispensing Systems (ADS) have been small-scale. Maximising efficiencies through automation relies on the effective introduction of technologies as well as the alignment of technical and social change, and there has been little exploration of how automation impacts on the staff experience and team effectiveness. In the literature there are numerous models available against which to compare and analyse the success of teams more generally. Underpinning many of these models is the Hackman model which proposes that team effectiveness is influenced by: the effort team members exhibit; the knowledge and skills team members possess; and the appropriateness of the performance strategies implemented. There is a gap in the literature on the impacts large-scale automation has on teams (and their success) in healthcare, specifically in pharmacy. Approved in August 2008, NHS Greater Glasgow & Clyde (GG&C) initiated a large-scale redesign (the PPSU Acute Pharmacy Redesign Programme). The Programme aimed to; provide a single procurement department for Glasgow pharmacy; have a centralised Pharmacy Distribution Centre (PDC); introduce ward-level ordering; and improve the current staff skill-mix while promoting the use of patients’ own medicines in hospital (Making the Most of Your Medicines or MMyM). Since opening in September 2010, the PDC (comprising 9 robots in total) is now the single facility responsible for the procurement and distribution of medicines to approximately 4000 destinations, and affected approximately 530 hospital pharmacy staff. This scale of pharmacy redesign has not been seen in any other automated schemes in the UK. The aim of the first study was to describe and evaluate NHS GG&C pharmacy staff experiences over the programme duration by different job roles/locations. Interviews were conducted with 36 pharmacy staff members from 4 hospital sites and the PDC, and 9 stakeholders, identified by members of the project Steering Group. Staff were interviewed about their experiences before, during and after the redesign. An inductive content analysis was performed, which produced two main themes: “The Work I Do” and “The Context of My Work”. The first theme allowed the exploration of the changes in staff job role, with a focus on tasks, work pace/control, morale, training/progression opportunities and voice/relationships. The second theme focused on social impacts of the redesign, including support, leadership, praise, reliability and trust of co-workers. Results showed that there was a lack of training available and morale was low in part due to this. There was no cohesive vision among participants as to why the redesign was happening. Hospital staff training was in theory available, yet completing training, and progressing into higher pay bands was not always feasible. Management were concerned with PDC technicians losing their clinical-skills as a result of a change in job location. PDC support workers experienced a gradual depletion of medicines knowledge due to this transition. The pharmacist role was seen as more social. Experiences between MMyM and non-MMyM staff were different in terms of how challenging, varied and social the work was. All roles within the PDC appeared to be less social compared with hospital roles. The aims of the second study were to apply Hackman’s model of team effectiveness in the context of the pharmacy team dynamics and performance and (based on this model) discuss the extent to which these teams were successful in the adoption of the automation. Hackman’s characteristics were applied to the pharmacy staff interviews (n=36). The results indicated that PDC and hospital teams exhibited 8 of the 23 characteristics: members have a variety of high-level skills; members contribute and are motivated equally; members are equally committed; members have personal and professional skills; relevant education and training is present; learning should be collective; members self-regulate; and there is clarity about task requirements, constraints, resources available and who the service user is. The “minimising of performance slippages” characteristic could be observed in one hospital team but not in the PDC. The teams did not exhibit 5 of the characteristics, indicating less success in these areas: autonomy is available; adequate feedback is available; excellent performance is rewarded; team size is appropriate; and relevant education and training is actually available. Nine of Hackman’s characteristics could not be commented on due to a lack of illustrative data. This thesis adds to the limited literature on the exploration of automation in healthcare, specifically pharmacy. Three main lessons can be concluded: staff consultation and engagement is critical to the successful redesign of services driven by technology; ensuring job role components are appropriate for job tasks is essential- technology adoption may require new skill sets and also cause other pre-existing skill sets to become lost; team effectiveness is an important focus within any organisational change programme, but less up-to-date models of team effectiveness may not be ideally applicable to teams utilising technology. These lessons align with current Scottish Government policy on pharmacy innovation and provide valuable key points for change implementers to support the continued adoption of automation locally, nationally and internationally

    An Exploration of the Suitability of Pharmacy Education in Saudi Arabia to Prepare Graduates to Meet Healthcare Needs: a Mixed-Methods Study

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    The key role of pharmacists within the health system, particularly in optimising safe, responsible and effective use of medicines, underpins the demand for a highly skilled and competent workforce. Therefore, developing the capacity of pharmacists to attain and maintain essential competencies relevant to the population’s health needs is required to ensure a high standard of patient care, thereby helping to improve patient and population health. In Saudi Arabia, little evidence exists regarding the assessment of national educational programmes’ structure and outcomes. Moreover, no national competency framework exists for pharmacists in any sector or stage of practice. In the absence of such core quality elements to inform pharmacy education assessment and development, the extent to which pharmacy schools in Saudi Arabia prepare competent pharmacists to address societal needs from pharmacy services is unclear. Therefore, this study aimed to explore the extent to which pharmacy education can prepare competent pharmacists to address the healthcare needs for pharmacy practice in Saudi Arabia. An exploratory sequential mixed methods research design was used to address the aim of this study in three phases: individual interviews and focus groups were employed with a purposively selected sample of pharmacy policy makers, pharmacists and the public to explore societal healthcare needs and the roles required of pharmacists to meet those needs; a national online survey of pharmacists and an online nominal group consensus method of pharmacy experts were used to identify competencies considered essential to develop a profession-wide national foundation level competency framework; and a case study in which curriculum mapping of two purposively selected Doctor of Pharmacy (PharmD) curricula was used to assess the extent to which the current pharmacy programme in Saudi Arabia meets the identified competencies of the developed national competency framework. Based on qualitative and quantitative analyses of societal healthcare needs, pharmacists’ roles, core competencies and curricular contents within the local context of Saudi Arabia, findings showed that there is a mismatch between initial education and real practice needs and expectations. While the country’s current needs from pharmacists are to optimise health system capacity and increase access to primary care services and medicines expertise in community pharmacies, the study indicated local education is product-oriented with a focus of curricular content and experiential training opportunities in most schools on preparing future pharmacists for hospital pharmacy practice. The study also identified several gaps between current initial education programmes and the competencies required to practise the expected roles, suggesting that current initial education might not prepare the students sufficiently to provide the full range of quality pharmaceutical services as per the country’s pharmacy practice needs. The study provided a new understanding of graduates’ readiness to practise as per the country’s pharmacy practice needs, the quality of educational programmes and pharmacists' professional development opportunities in Saudi Arabia. Findings maybe used to inform the development of competency-based education and maximise graduates’ capacity to deliver and develop pharmaceutical services effectively to best meet societal healthcare needs in Saudi Arabia
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