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Improving specialist drug prescribing in primary care using task and error analysis: an observational study
Narinder Chana1, Talya Porat2, Cate Whittlesea3
1NHS Richmond Clinical Commissioning Group, Twickenham, London.
Summary
A clinical decision support system (CDSS) can help general practitioners (GPs) safely prescribe specialist drugs. The current process has errors, especially omissions, which a CDSS could mitigate to improve patient safety.
Area of Science:
- Health Informatics
- General Practice
- Pharmacology
Background:
- Computerised clinical decision support systems (CDSSs) have improved electronic prescribing.
- No studies have assessed CDSSs for supporting GPs in prescribing specialist drugs.
Purpose of the Study:
- Identify weaknesses and errors in specialist drug prescribing by GPs.
- Inform the development of a CDSS to address these issues.
Main Methods:
- Semi-structured interviews with key informants.
- Observational study of GPs in the UK performing prescribing scenarios.
- Activity diagrams, hierarchical task analysis, and Systematic Human Error Reduction and Prediction Approach (SHERPA) analyses.
Main Results:
- The current specialist drug prescribing process for GPs is error-prone.
- Errors of omission due to lack of information were most common.
- Half of potential prescribing errors had a high probability of occurrence.
Conclusions:
- A CDSS is needed to support GPs in prescribing specialist drugs.
- CDSS could aid decisions on undertaking prescribing and link to shared care protocols.
- Implementation could reduce errors and enhance patient safety.
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