Optimizing Hospital Electronic Prescribing Systems: A Systematic Scoping Review

被引：8

作者：

Williams, Jac ^{[1
]}

Malden, Stephen ^{[1
]}

Heeney, Catherine ^{[1
]}

Bouamrane, Matt ^{[1
]}

Holder, Mike ^{[1
]}

Perera, Uditha ^{[1
]}

Bates, David W. ^{[2
]}

Sheikh, Aziz ^{[1
]}

机构：

[1] Univ Edinburgh, Usher Inst, Edinburgh, Midlothian, Scotland

[2] Brigham & Womens Hosp, Div Gen Internal Med & Primary Care, 75 Francis St, Boston, MA 02115 USA

来源：

JOURNAL OF PATIENT SAFETY | 2022年 / 18卷 / 02期

基金：

英国医学研究理事会;

关键词：

patient safety; quality; efficiency; ePrescribing; health IT; medicines management; CLINICAL DECISION-SUPPORT; ANTIMICROBIAL STEWARDSHIP PROGRAM; ORDER SET; MEDICAL-RECORD; IMPACT; IMPLEMENTATION; INTERVENTION; TIME; IMPROVEMENT; BUNDLE;

D O I：

10.1097/PTS.0000000000000867

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective Considerable international investment in hospital electronic prescribing (ePrescribing) systems has been made, but despite this, it is proving difficult for most organizations to realize safety, quality, and efficiency gains in prescribing. The objective of this work was to develop policy-relevant insights into the optimization of hospital ePrescribing systems to maximize the benefits and minimize the risks of these expensive digital health infrastructures. Methods We undertook a systematic scoping review of the literature by searching MEDLINE, Embase, and CINAHL databases. We searched for primary studies reporting on ePrescribing optimization strategies and independently screened and abstracted data until saturation was achieved. Findings were theoretically and thematically synthesized taking a medicine life-cycle perspective, incorporating consultative phases with domain experts. Results We identified 23,609 potentially eligible studies from which 1367 satisfied our inclusion criteria. Thematic synthesis was conducted on a data set of 76 studies, of which 48 were based in the United States. Key approaches to optimization included the following: stakeholder engagement, system or process redesign, technological innovations, and education and training packages. Single-component interventions (n = 26) described technological optimization strategies focusing on a single, specific step in the prescribing process. Multicomponent interventions (n = 50) used a combination of optimization strategies, typically targeting multiple steps in the medicines management process. Discussion We identified numerous optimization strategies for enhancing the performance of ePrescribing systems. Key considerations for ePrescribing optimization include meaningful stakeholder engagement to reconceptualize the service delivery model and implementing technological innovations with supporting training packages to simultaneously impact on different facets of the medicines management process.

引用

页码：E547 / E562

页数：16

共 91 条

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