Understanding the causes of prescribing errors from a behavioural perspective.

Area of Science:

• Medical Safety
• Behavioral Science
• Pediatric Oncology

Background:

• Prescribing errors (PEs) remain a persistent challenge in healthcare despite numerous interventions.
• Understanding the underlying prescriber behaviors is crucial for developing effective error reduction strategies.

Purpose of the Study:

• To explore the behaviors contributing to PEs in senior doctors within a pediatric inpatient oncology ward.
• To apply the Capability, Opportunity, Motivation - Behavior (COM-B) model to analyze these behaviors.

Main Methods:

• A qualitative approach was employed in a 26-bed pediatric oncology ward.
• Error data were collected over two months and discussed in focus groups with prescribers.
• Thematic analysis was used to identify behavioral factors using the COM-B model.

Main Results:

• Capability-related behaviors included insufficient skills and knowledge leading to incorrect prescribing.
• Opportunity-related behaviors involved poor patient information access, heavy workload, and interruptions.
• Motivation-related behaviors included over-reliance on recommendations and task prioritization conflicts.

Conclusions:

• The COM-B model offers a novel perspective for identifying the sources of PEs.
• Future interventions should map identified behavioral factors to targeted intervention functions and policies for improved success.