Comparing safety, performance and user perceptions of a patient-specific indication-based prescribing tool with...

Area of Science:

• Medical Informatics
• Patient Safety
• Clinical Decision Support Systems

Background:

• Medication errors are a major cause of preventable harm in healthcare.
• Existing clinical decision support systems (CDSS) have limitations in preventing these errors.
• An indication-based prescribing tool was developed to address these limitations.

Purpose of the Study:

• To compare the incidence and types of medication prescribing errors with and without the new indication-based prescribing tool.
• To evaluate the impact on time to prescribe (TTP) and perceived workload (NASA-TLX).
• To identify workflow vulnerabilities and gather user feedback.

Main Methods:

• A simulated, randomized, cross-over study at a London NHS Trust.
• 24 participants completed prescribing tasks with and without the intervention.
• Data collected via direct observation, NASA-TLX, and semistructured interviews.

Main Results:

• The intervention significantly reduced prescribing errors from 28.3% to 6.6% (OR 0.18, p<0.01).
• Shorter time to prescribe and lower perceived workload (NASA-TLX) were observed with the tool.
• Errors in the control group included incorrect doses and limits; intervention errors involved misidentifying patient information.

Conclusions:

• The indication-based prescribing tool is a promising advancement for medication safety and prescribing efficiency.
• Further real-world evaluation is needed for diverse patient groups and settings.
• The system requires development to meet broader user and healthcare needs.