Errors resulting from the use of electronic systems – stakeholder perceptions on how to reduce them

Abstract

Background: Electronic medication management (eMeds) systems improve medication safety, but simultaneously introduce new system-related errors; errors that were not possible with the use of paper records. We know very little about strategies used in Australian settings to reduce system-related errors.

Aims: To explore stakeholders’ perceptions and experiences of interventions that were implemented to reduce system-related errors associated with the use of eMeds, as well as other changes they believe could further reduce these errors in the future.

Methods: Semi-structured interviews were conducted with users of eMeds and stakeholders with eMeds supporting roles in a NSW Local Health District. Discussions focused on interventions which had targeted or reduced system-related errors, in addition to future changes needed to stop these errors from occurring. Interviews were audio-recorded, transcribed verbatim, and analysis was conducted iteratively using an inductive approach.

Results: Twenty-five participants took part. Participants described the redesign of eMeds as central to decreasing system-related errors, with examples of system changes described, including pop-up alerts and changes to the visual display. Increased monitoring of system use was also perceived to reduce errors. However, participants indicated that in some cases, redesign at the local level was not possible, so increased training and support was needed. Future recommended changes included more effective alerts, and a more intuitive system, as well as ongoing training.

Conclusions: Redesign of eMeds was a frequent strategy used to reduce system-related errors, but not all desired system changes were possible at a local level. Ensuring that users are well-supported in using the system and monitoring how users interact with the system will likely reduce system-related errors.