Medication Review: Human Factors Study Aiming at Helping an Acute Geriatric Unit to Sustain and Systematize the...

Area of Science:

• Geriatric Medicine
• Health Systems Pharmacy
• Human Factors Engineering

Background:

• Medication Review (MRev) is crucial for patient safety but challenging to implement without key resources.
• This study examines an MRev process in an Acute Geriatric Unit (AGU) lacking Computerized Physician Order Entry (CPOE) and adequate staffing.
• The AGU's MRev process faced implementation hurdles due to resource limitations.

Purpose of the Study:

• To describe the existing MRev process in the AGU, focusing on the preparatory meeting phase.
• To identify challenges and propose recommendations for maintaining and optimizing the MRev process.
• To analyze the effectiveness of MRev under suboptimal conditions.

Main Methods:

• Human Factors experts conducted data collection from April to October 2014 at Lille University Hospital.
• Methods included interviews, shadowing observations, and video recording of the MRev process.
• Analysis focused on actors, tools, outcomes, and difficulties within the MRev phases.

Main Results:

• The MRev process involves three phases: meeting preparation, the MRev meeting, and patient discharge.
• Seven main tasks were identified, with actors, supports, outcomes, and difficulties documented for each.
• While a full-time pharmacist would be ideal, practical recommendations include targeted training and process enhancements.

Conclusions:

• The AGU demonstrated an efficient Medication Review process despite operating under less than ideal conditions.
• Well-designed tools and established processes contributed to the effectiveness of the MRev.
• Optimizing actor training and refining specific task processes are key recommendations for sustained MRev success.