Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Effects of two commercial electronic prescribing systems on prescribing error rates in hospital in-patients: A before and after study", "type"=>"journal", "authors"=>[{"first_name"=>"Johanna I.", "last_name"=>"Westbrook", "scopus_author_id"=>"7005961363"}, {"first_name"=>"Margaret", "last_name"=>"Reckmann", "scopus_author_id"=>"55525321300"}, {"first_name"=>"Ling", "last_name"=>"Li", "scopus_author_id"=>"56477447300"}, {"first_name"=>"William B.", "last_name"=>"Runciman", "scopus_author_id"=>"7005331766"}, {"first_name"=>"Rosemary", "last_name"=>"Burke", "scopus_author_id"=>"8118002900"}, {"first_name"=>"Connie", "last_name"=>"Lo", "scopus_author_id"=>"56315145800"}, {"first_name"=>"Melissa T.", "last_name"=>"Baysari", "scopus_author_id"=>"6505614589"}, {"first_name"=>"Jeffrey", "last_name"=>"Braithwaite", "scopus_author_id"=>"7006823309"}, {"first_name"=>"Richard O.", "last_name"=>"Day", "scopus_author_id"=>"56962776900"}], "year"=>2012, "source"=>"PLoS Medicine", "identifiers"=>{"sgr"=>"84856495580", "doi"=>"10.1371/journal.pmed.1001164", "isbn"=>"1549-1676 (Electronic)\\r1549-1277 (Linking)", "pmid"=>"22303286", "issn"=>"15491277", "scopus"=>"2-s2.0-84856495580", "pui"=>"364181059"}, "id"=>"6f0f122f-ff86-36e6-8fb4-2fb8f8fb9176", "abstract"=>"BACKGROUND Considerable investments are being made in commercial electronic prescribing systems (e-prescribing) in many countries. Few studies have measured or evaluated their effectiveness at reducing prescribing error rates, and interactions between system design and errors are not well understood, despite increasing concerns regarding new errors associated with system use. This study evaluated the effectiveness of two commercial e-prescribing systems in reducing prescribing error rates and their propensities for introducing new types of error. METHODS AND RESULTS We conducted a before and after study involving medication chart audit of 3,291 admissions (1,923 at baseline and 1,368 post e-prescribing system) at two Australian teaching hospitals. In Hospital A, the Cerner Millennium e-prescribing system was implemented on one ward, and three wards, which did not receive the e-prescribing system, acted as controls. In Hospital B, the iSoft MedChart system was implemented on two wards and we compared before and after error rates. Procedural (e.g., unclear and incomplete prescribing orders) and clinical (e.g., wrong dose, wrong drug) errors were identified. Prescribing error rates per admission and per 100 patient days; rates of serious errors (5-point severity scale, those ≥3 were categorised as serious) by hospital and study period; and rates and categories of postintervention \"system-related\" errors (where system functionality or design contributed to the error) were calculated. Use of an e-prescribing system was associated with a statistically significant reduction in error rates in all three intervention wards (respectively reductions of 66.1% [95% CI 53.9%-78.3%]; 57.5% [33.8%-81.2%]; and 60.5% [48.5%-72.4%]). The use of the system resulted in a decline in errors at Hospital A from 6.25 per admission (95% CI 5.23-7.28) to 2.12 (95% CI 1.71-2.54; p<0.0001) and at Hospital B from 3.62 (95% CI 3.30-3.93) to 1.46 (95% CI 1.20-1.73; p<0.0001). This decrease was driven by a large reduction in unclear, illegal, and incomplete orders. The Hospital A control wards experienced no significant change (respectively -12.8% [95% CI -41.1% to 15.5%]; -11.3% [-40.1% to 17.5%]; -20.1% [-52.2% to 12.4%]). There was limited change in clinical error rates, but serious errors decreased by 44% (0.25 per admission to 0.14; p = 0.0002) across the intervention wards compared to the control wards (17% reduction; 0.30-0.25; p = 0.40). Both hospitals experienced system-related errors (0.73 and 0.51 per admission), which accounted for 35% of postsystem errors in the intervention wards; each system was associated with different types of system-related errors. CONCLUSIONS Implementation of these commercial e-prescribing systems resulted in statistically significant reductions in prescribing error rates. Reductions in clinical errors were limited in the absence of substantial decision support, but a statistically significant decline in serious errors was observed. System-related errors require close attention as they are frequent, but are potentially remediable by system redesign and user training. Limitations included a lack of control wards at Hospital B and an inability to randomize wards to the intervention.", "link"=>"http://www.mendeley.com/research/effects-two-commercial-electronic-prescribing-systems-prescribing-error-rates-hospital-inpatients-be", "reader_count"=>124, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>6, "Librarian"=>1, "Student > Doctoral Student"=>5, "Researcher"=>11, "Student > Ph. D. Student"=>21, "Student > Postgraduate"=>11, "Student > Master"=>25, "Other"=>17, "Student > Bachelor"=>11, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>9}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>6, "Librarian"=>1, "Student > Doctoral Student"=>5, "Researcher"=>11, "Student > Ph. D. Student"=>21, "Student > Postgraduate"=>11, "Student > Master"=>25, "Other"=>17, "Student > Bachelor"=>11, "Lecturer"=>4, "Lecturer > Senior Lecturer"=>1, "Professor"=>9}, "reader_count_by_subject_area"=>{"Engineering"=>5, "Unspecified"=>3, "Environmental Science"=>2, "Nursing and Health Professions"=>3, "Agricultural and Biological Sciences"=>5, "Medicine and Dentistry"=>66, "Business, Management and Accounting"=>5, "Pharmacology, Toxicology and Pharmaceutical Science"=>12, "Psychology"=>3, "Social Sciences"=>7, "Computer Science"=>12, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>5}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>66}, "Social Sciences"=>{"Social Sciences"=>7}, "Psychology"=>{"Psychology"=>3}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>5}, "Computer Science"=>{"Computer Science"=>12}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>5}, "Unspecified"=>{"Unspecified"=>3}, "Environmental Science"=>{"Environmental Science"=>2}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>12}}, "reader_count_by_country"=>{"New Zealand"=>1, "Canada"=>1, "Argentina"=>1, "Sweden"=>1, "Iran"=>1, "United States"=>2, "Brazil"=>3, "United Kingdom"=>3, "United Arab Emirates"=>1, "France"=>1, "Australia"=>1, "Spain"=>1}, "group_count"=>7}

CrossRef

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84856495580"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/84856495580?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84856495580&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=84856495580&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/84856495580", "dc:identifier"=>"SCOPUS_ID:84856495580", "eid"=>"2-s2.0-84856495580", "dc:title"=>"Effects of two commercial electronic prescribing systems on prescribing error rates in hospital in-patients: A before and after study", "dc:creator"=>"Westbrook J.", "prism:publicationName"=>"PLoS Medicine", "prism:issn"=>"15491277", "prism:eIssn"=>"15491676", "prism:volume"=>"9", "prism:issueIdentifier"=>"1", "prism:pageRange"=>nil, "prism:coverDate"=>"2012-01-01", "prism:coverDisplayDate"=>"January 2012", "prism:doi"=>"10.1371/journal.pmed.1001164", "citedby-count"=>"109", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"University of New South Wales (UNSW) Australia", "affiliation-city"=>"Sydney", "affiliation-country"=>"Australia"}], "pubmed-id"=>"22303286", "prism:aggregationType"=>"Journal", "subtype"=>"ar", "subtypeDescription"=>"Article", "article-number"=>"e1001164", "source-id"=>"144840", "openaccess"=>"1", "openaccessFlag"=>true}

Facebook

  • {"url"=>"http%3A%2F%2Fjournals.plos.org%2Fplosmedicine%2Farticle%3Fid%3D10.1371%252Fjournal.pmed.1001164", "share_count"=>0, "like_count"=>0, "comment_count"=>0, "click_count"=>0, "total_count"=>0}

Journal Comments | Further Information

Twitter

Counter

  • {"month"=>"1", "year"=>"2012", "pdf_views"=>"49", "xml_views"=>"1", "html_views"=>"455"}
  • {"month"=>"2", "year"=>"2012", "pdf_views"=>"691", "xml_views"=>"53", "html_views"=>"4174"}
  • {"month"=>"3", "year"=>"2012", "pdf_views"=>"105", "xml_views"=>"7", "html_views"=>"674"}
  • {"month"=>"4", "year"=>"2012", "pdf_views"=>"89", "xml_views"=>"3", "html_views"=>"494"}
  • {"month"=>"5", "year"=>"2012", "pdf_views"=>"75", "xml_views"=>"4", "html_views"=>"371"}
  • {"month"=>"6", "year"=>"2012", "pdf_views"=>"63", "xml_views"=>"3", "html_views"=>"352"}
  • {"month"=>"7", "year"=>"2012", "pdf_views"=>"48", "xml_views"=>"1", "html_views"=>"246"}
  • {"month"=>"8", "year"=>"2012", "pdf_views"=>"47", "xml_views"=>"9", "html_views"=>"266"}
  • {"month"=>"9", "year"=>"2012", "pdf_views"=>"45", "xml_views"=>"1", "html_views"=>"391"}
  • {"month"=>"10", "year"=>"2012", "pdf_views"=>"63", "xml_views"=>"3", "html_views"=>"460"}
  • {"month"=>"11", "year"=>"2012", "pdf_views"=>"64", "xml_views"=>"1", "html_views"=>"398"}
  • {"month"=>"12", "year"=>"2012", "pdf_views"=>"40", "xml_views"=>"0", "html_views"=>"360"}
  • {"month"=>"1", "year"=>"2013", "pdf_views"=>"25", "xml_views"=>"3", "html_views"=>"355"}
  • {"month"=>"2", "year"=>"2013", "pdf_views"=>"44", "xml_views"=>"3", "html_views"=>"320"}
  • {"month"=>"3", "year"=>"2013", "pdf_views"=>"29", "xml_views"=>"1", "html_views"=>"240"}
  • {"month"=>"4", "year"=>"2013", "pdf_views"=>"34", "xml_views"=>"1", "html_views"=>"364"}
  • {"month"=>"5", "year"=>"2013", "pdf_views"=>"35", "xml_views"=>"0", "html_views"=>"302"}
  • {"month"=>"6", "year"=>"2013", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"260"}
  • {"month"=>"7", "year"=>"2013", "pdf_views"=>"24", "xml_views"=>"0", "html_views"=>"271"}
  • {"month"=>"8", "year"=>"2013", "pdf_views"=>"36", "xml_views"=>"3", "html_views"=>"222"}
  • {"month"=>"9", "year"=>"2013", "pdf_views"=>"32", "xml_views"=>"1", "html_views"=>"273"}
  • {"month"=>"10", "year"=>"2013", "pdf_views"=>"46", "xml_views"=>"2", "html_views"=>"305"}
  • {"month"=>"11", "year"=>"2013", "pdf_views"=>"29", "xml_views"=>"2", "html_views"=>"295"}
  • {"month"=>"12", "year"=>"2013", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"263"}
  • {"month"=>"1", "year"=>"2014", "pdf_views"=>"31", "xml_views"=>"2", "html_views"=>"233"}
  • {"month"=>"2", "year"=>"2014", "pdf_views"=>"25", "xml_views"=>"0", "html_views"=>"330"}
  • {"month"=>"3", "year"=>"2014", "pdf_views"=>"37", "xml_views"=>"2", "html_views"=>"428"}
  • {"month"=>"4", "year"=>"2014", "pdf_views"=>"29", "xml_views"=>"2", "html_views"=>"346"}
  • {"month"=>"5", "year"=>"2014", "pdf_views"=>"34", "xml_views"=>"1", "html_views"=>"373"}
  • {"month"=>"6", "year"=>"2014", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"338"}
  • {"month"=>"7", "year"=>"2014", "pdf_views"=>"22", "xml_views"=>"2", "html_views"=>"243"}
  • {"month"=>"8", "year"=>"2014", "pdf_views"=>"19", "xml_views"=>"3", "html_views"=>"261"}
  • {"month"=>"9", "year"=>"2014", "pdf_views"=>"33", "xml_views"=>"3", "html_views"=>"353"}
  • {"month"=>"10", "year"=>"2014", "pdf_views"=>"42", "xml_views"=>"2", "html_views"=>"424"}
  • {"month"=>"11", "year"=>"2014", "pdf_views"=>"28", "xml_views"=>"2", "html_views"=>"411"}
  • {"month"=>"12", "year"=>"2014", "pdf_views"=>"16", "xml_views"=>"3", "html_views"=>"219"}
  • {"month"=>"1", "year"=>"2015", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"205"}
  • {"month"=>"2", "year"=>"2015", "pdf_views"=>"38", "xml_views"=>"0", "html_views"=>"224"}
  • {"month"=>"3", "year"=>"2015", "pdf_views"=>"33", "xml_views"=>"0", "html_views"=>"210"}
  • {"month"=>"4", "year"=>"2015", "pdf_views"=>"22", "xml_views"=>"1", "html_views"=>"208"}
  • {"month"=>"5", "year"=>"2015", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"200"}
  • {"month"=>"6", "year"=>"2015", "pdf_views"=>"38", "xml_views"=>"1", "html_views"=>"212"}
  • {"month"=>"7", "year"=>"2015", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"181"}
  • {"month"=>"8", "year"=>"2015", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"167"}
  • {"month"=>"9", "year"=>"2015", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"198"}
  • {"month"=>"10", "year"=>"2015", "pdf_views"=>"29", "xml_views"=>"0", "html_views"=>"176"}
  • {"month"=>"11", "year"=>"2015", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"211"}
  • {"month"=>"12", "year"=>"2015", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"194"}
  • {"month"=>"1", "year"=>"2016", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"156"}
  • {"month"=>"2", "year"=>"2016", "pdf_views"=>"34", "xml_views"=>"0", "html_views"=>"235"}
  • {"month"=>"3", "year"=>"2016", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"202"}
  • {"month"=>"4", "year"=>"2016", "pdf_views"=>"38", "xml_views"=>"0", "html_views"=>"208"}
  • {"month"=>"5", "year"=>"2016", "pdf_views"=>"30", "xml_views"=>"0", "html_views"=>"167"}
  • {"month"=>"6", "year"=>"2016", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"111"}
  • {"month"=>"7", "year"=>"2016", "pdf_views"=>"21", "xml_views"=>"0", "html_views"=>"107"}
  • {"month"=>"8", "year"=>"2016", "pdf_views"=>"42", "xml_views"=>"0", "html_views"=>"143"}
  • {"month"=>"9", "year"=>"2016", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"230"}
  • {"month"=>"10", "year"=>"2016", "pdf_views"=>"52", "xml_views"=>"0", "html_views"=>"306"}
  • {"month"=>"11", "year"=>"2016", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"229"}
  • {"month"=>"12", "year"=>"2016", "pdf_views"=>"16", "xml_views"=>"1", "html_views"=>"244"}
  • {"month"=>"1", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"2", "html_views"=>"382"}
  • {"month"=>"2", "year"=>"2017", "pdf_views"=>"26", "xml_views"=>"0", "html_views"=>"229"}
  • {"month"=>"3", "year"=>"2017", "pdf_views"=>"21", "xml_views"=>"3", "html_views"=>"295"}
  • {"month"=>"4", "year"=>"2017", "pdf_views"=>"19", "xml_views"=>"1", "html_views"=>"446"}
  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"17", "xml_views"=>"1", "html_views"=>"113"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"12", "xml_views"=>"2", "html_views"=>"102"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"154"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"17", "xml_views"=>"1", "html_views"=>"171"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"228"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"296"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"35", "xml_views"=>"3", "html_views"=>"220"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"11", "xml_views"=>"2", "html_views"=>"147"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"117"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"53", "xml_views"=>"0", "html_views"=>"44"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"84", "xml_views"=>"0", "html_views"=>"121"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"50", "xml_views"=>"0", "html_views"=>"85"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"60", "xml_views"=>"1", "html_views"=>"83"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"42", "xml_views"=>"4", "html_views"=>"45"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"46", "xml_views"=>"4", "html_views"=>"37"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"57", "xml_views"=>"1", "html_views"=>"60"}
  • {"month"=>"9", "year"=>"2018", "pdf_views"=>"55", "xml_views"=>"2", "html_views"=>"59"}
  • {"month"=>"10", "year"=>"2018", "pdf_views"=>"51", "xml_views"=>"2", "html_views"=>"98"}
  • {"month"=>"11", "year"=>"2018", "pdf_views"=>"52", "xml_views"=>"1", "html_views"=>"90"}
  • {"month"=>"12", "year"=>"2018", "pdf_views"=>"57", "xml_views"=>"0", "html_views"=>"42"}
  • {"month"=>"1", "year"=>"2019", "pdf_views"=>"41", "xml_views"=>"0", "html_views"=>"29"}
  • {"month"=>"2", "year"=>"2019", "pdf_views"=>"34", "xml_views"=>"0", "html_views"=>"54"}
  • {"month"=>"3", "year"=>"2019", "pdf_views"=>"66", "xml_views"=>"1", "html_views"=>"52"}
  • {"month"=>"4", "year"=>"2019", "pdf_views"=>"62", "xml_views"=>"0", "html_views"=>"65"}
  • {"month"=>"5", "year"=>"2019", "pdf_views"=>"69", "xml_views"=>"1", "html_views"=>"69"}
  • {"month"=>"6", "year"=>"2019", "pdf_views"=>"51", "xml_views"=>"0", "html_views"=>"40"}
  • {"month"=>"7", "year"=>"2019", "pdf_views"=>"43", "xml_views"=>"0", "html_views"=>"46"}
  • {"month"=>"8", "year"=>"2019", "pdf_views"=>"28", "xml_views"=>"0", "html_views"=>"24"}

Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/686955"], "description"=>"<p>Adm, number of admissions; <i>n</i>, number of serious errors.</p>", "links"=>[], "tags"=>["errors"], "article_id"=>357440, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.t004", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Serious_errors_per_admission_by_study_group_and_period_/357440", "title"=>"Serious errors per admission by study group and period.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-31 02:04:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/687045"], "description"=>"<p>Errors/admission (95% CI); <i>n</i>, number of errors.</p>", "links"=>[], "tags"=>["baseline", "prescribing", "rates"], "article_id"=>357530, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.t001", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_baseline_prescribing_error_rates_by_hospital_/357530", "title"=>"Summary of baseline prescribing error rates by hospital.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-31 02:05:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/687119"], "description"=>"<p>Adm, the number of admissions; <i>n</i>, number of errors.</p>a<p>Indicates the four most frequent error types in each ward.</p>", "links"=>[], "tags"=>["rates", "ward"], "article_id"=>357603, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.t002", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prescribing_error_rates_per_admission_by_hospital_ward_type_error_category_and_error_type_at_baseline_/357603", "title"=>"Prescribing error rates per admission by hospital, ward type, error category, and error type at baseline.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-31 02:06:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/686918"], "description"=>"<p>Excludes 358 system-related prescribing errors that occurred in the intervention wards in the post period (See <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001164#pmed-1001164-t006\" target=\"_blank\">Table 6</a> for further details of these).</p>", "links"=>[], "tags"=>["errors"], "article_id"=>357400, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.t005", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prescribing_errors_by_type_category_hospital_and_period_for_the_intervention_and_control_wards_/357400", "title"=>"Prescribing errors by type, category, hospital, and period for the intervention and control wards.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-31 02:03:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/350135", "https://ndownloader.figshare.com/files/350167"], "description"=>"<div><h3>Background</h3><p>Considerable investments are being made in commercial electronic prescribing systems (e-prescribing) in many countries. Few studies have measured or evaluated their effectiveness at reducing prescribing error rates, and interactions between system design and errors are not well understood, despite increasing concerns regarding new errors associated with system use. This study evaluated the effectiveness of two commercial e-prescribing systems in reducing prescribing error rates and their propensities for introducing new types of error.</p> <h3>Methods and Results</h3><p>We conducted a before and after study involving medication chart audit of 3,291 admissions (1,923 at baseline and 1,368 post e-prescribing system) at two Australian teaching hospitals. In Hospital A, the Cerner Millennium e-prescribing system was implemented on one ward, and three wards, which did not receive the e-prescribing system, acted as controls. In Hospital B, the iSoft MedChart system was implemented on two wards and we compared before and after error rates. Procedural (e.g., unclear and incomplete prescribing orders) and clinical (e.g., wrong dose, wrong drug) errors were identified. Prescribing error rates per admission and per 100 patient days; rates of serious errors (5-point severity scale, those ≥3 were categorised as serious) by hospital and study period; and rates and categories of postintervention “system-related” errors (where system functionality or design contributed to the error) were calculated. Use of an e-prescribing system was associated with a statistically significant reduction in error rates in all three intervention wards (respectively reductions of 66.1% [95% CI 53.9%–78.3%]; 57.5% [33.8%–81.2%]; and 60.5% [48.5%–72.4%]). The use of the system resulted in a decline in errors at Hospital A from 6.25 per admission (95% CI 5.23–7.28) to 2.12 (95% CI 1.71–2.54; <em>p</em><0.0001) and at Hospital B from 3.62 (95% CI 3.30–3.93) to 1.46 (95% CI 1.20–1.73; <em>p</em><0.0001). This decrease was driven by a large reduction in unclear, illegal, and incomplete orders. The Hospital A control wards experienced no significant change (respectively −12.8% [95% CI −41.1% to 15.5%]; −11.3% [−40.1% to 17.5%]; −20.1% [−52.2% to 12.4%]). There was limited change in clinical error rates, but serious errors decreased by 44% (0.25 per admission to 0.14; <em>p</em> = 0.0002) across the intervention wards compared to the control wards (17% reduction; 0.30–0.25; <em>p</em> = 0.40). Both hospitals experienced system-related errors (0.73 and 0.51 per admission), which accounted for 35% of postsystem errors in the intervention wards; each system was associated with different types of system-related errors.</p> <h3>Conclusions</h3><p>Implementation of these commercial e-prescribing systems resulted in statistically significant reductions in prescribing error rates. Reductions in clinical errors were limited in the absence of substantial decision support, but a statistically significant decline in serious errors was observed. System-related errors require close attention as they are frequent, but are potentially remediable by system redesign and user training. Limitations included a lack of control wards at Hospital B and an inability to randomize wards to the intervention.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["effects", "prescribing", "systems", "rates"], "article_id"=>129209, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001164.s001", "https://dx.doi.org/10.1371/journal.pmed.1001164.s002"], "stats"=>{"downloads"=>8, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Effects_of_Two_Commercial_Electronic_Prescribing_Systems_on_Prescribing_Error_Rates_in_Hospital_In_Patients_A_Before_and_After_Study/129209", "title"=>"Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-01-31 02:33:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/686789"], "description"=>"<p>Outline of study design.</p>", "links"=>[], "tags"=>["Non-clinical medicine"], "article_id"=>357272, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.g001", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Outline_of_study_design_/357272", "title"=>"Outline of study design.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-01-31 02:01:12"}
  • {"files"=>["https://ndownloader.figshare.com/files/687000"], "description"=>"<p>The manifestation of system-related prescribing error rates by type and hospital.</p>", "links"=>[], "tags"=>["manifestation", "system-related", "prescribing", "rates"], "article_id"=>357477, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.t006", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_manifestation_of_system_related_prescribing_error_rates_by_type_and_hospital_/357477", "title"=>"The manifestation of system-related prescribing error rates by type and hospital.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-31 02:04:37"}
  • {"files"=>["https://ndownloader.figshare.com/files/687084"], "description"=>"<p>Includes system-related errors (<i>n</i> = 358), which occurred in the intervention wards in the postperiod.</p><p>Adm, number of admissions; <i>n</i>, number of errors.</p>", "links"=>[], "tags"=>["prescribing", "rates", "pre-", "postelectronic"], "article_id"=>357561, "categories"=>["Medicine"], "users"=>["Johanna I. Westbrook", "Margaret Reckmann", "Ling Li", "William B. Runciman", "Rosemary Burke", "Connie Lo", "Melissa T. Baysari", "Jeffrey Braithwaite", "Richard O. Day"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001164.t003", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Comparison_of_prescribing_error_rates_pre_and_postelectronic_prescribing_system_implementation_/357561", "title"=>"Comparison of prescribing error rates pre- and postelectronic prescribing system implementation.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-01-31 02:06:01"}

PMC Usage Stats | Further Information

  • {"unique-ip"=>"20", "full-text"=>"23", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"16", "full-text"=>"25", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"18", "full-text"=>"33", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"24", "full-text"=>"35", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"21", "full-text"=>"26", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"31", "full-text"=>"36", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"28", "full-text"=>"35", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"20", "full-text"=>"30", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"22", "full-text"=>"33", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"24", "full-text"=>"29", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"23", "full-text"=>"27", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"19", "full-text"=>"30", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"28", "full-text"=>"36", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"29", "full-text"=>"37", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"33", "full-text"=>"43", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"45", "full-text"=>"60", "pdf"=>"17", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"17", "full-text"=>"22", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"15", "full-text"=>"18", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"26", "full-text"=>"27", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"35", "full-text"=>"48", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"30", "full-text"=>"42", "pdf"=>"13", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"1", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"22", "full-text"=>"26", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"28", "full-text"=>"33", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"25", "full-text"=>"29", "pdf"=>"13", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"19", "full-text"=>"25", "pdf"=>"10", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"24", "full-text"=>"32", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"25", "full-text"=>"29", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"30", "full-text"=>"36", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"4", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"25", "full-text"=>"33", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"23", "full-text"=>"32", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"27", "full-text"=>"36", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"24", "full-text"=>"34", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"27", "full-text"=>"34", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}

Relative Metric

{"start_date"=>"2012-01-01T00:00:00Z", "end_date"=>"2012-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Immunology", "average_usage"=>[312, 555, 680, 785, 880, 965, 1057, 1142, 1230, 1312, 1394, 1471, 1547, 1613, 1681, 1743, 1805, 1871, 1941, 2010, 2071, 2128, 2202, 2266, 2323]}, {"subject_area"=>"/Computer and information sciences/Data visualization", "average_usage"=>[404, 618, 724, 839, 946, 1045, 1135, 1232, 1287, 1372, 1448, 1523, 1607, 1675, 1720, 1780, 1824, 1937, 1969, 2097, 2163, 2206, 2256, 2279, 2374]}, {"subject_area"=>"/Medicine and health sciences/Health care", "average_usage"=>[335, 575, 699, 804, 900, 994, 1119, 1215, 1317, 1408, 1509, 1583, 1664, 1732, 1802, 1873, 1945, 2020, 2104, 2190, 2259, 2325, 2400, 2463, 2548]}, {"subject_area"=>"/Medicine and health sciences/Pharmacology", "average_usage"=>[314, 554, 687, 796, 891, 983, 1075, 1170, 1261, 1340, 1422, 1504, 1574, 1647, 1715, 1786, 1848, 1919, 1990, 2053, 2115, 2197, 2258, 2333, 2395]}, {"subject_area"=>"/People and places/Population groupings", "average_usage"=>[325, 565, 687, 787, 880, 971, 1065, 1156, 1244, 1339, 1424, 1502, 1582, 1654, 1724, 1794, 1855, 1925, 1997, 2058, 2132, 2207, 2285, 2347, 2412]}]}
Loading … Spinner
There are currently no alerts