Bradford Drug Error Reporting System
RSS Home > Online First > Article BMJ Qual Saf doi:10.1136/bmjqs-2011-000443 Original research Development of an evidence-based framework of factors contributing to patient safety improving the quality of drug error reporting incidents in hospital settings: a systematic review Rebecca Lawton1, Rosemary R medication error reporting system C McEachan2, Sally J Giles2, Reema Sirriyeh1, Ian S Watt3, John Wright2 1Institute of Psychological Sciences, University of Leeds, Leeds, UK 2Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK 3Health Sciences, University of York, York, UK Correspondence to Dr Rebecca Lawton, Senior Lecturer in Health Psychology, Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT, UK; r.j.lawton{at}leeds.ac.uk Contributors RL and RM devised the review protocol. RM and RS performed searches according to protocol, coded studies and extracted data. RM, RL, SG, JW and IW developed the framework. RL, RM and SG contributed to the first draft of the manuscript. All authors commented on and revised subsequent drafts. All authors read and approved the final manuscript. RL is the guarantor. Accepted 24 January 2012 Published Online First 15 March 2012 Next Section Abstract Objective The aim of this systematic review was to develop a ‘contributory factors framework’ from a synthesis of empirical work which summarises factors contributing to patient safety incidents in hospital settings. Design A mixed-methods systematic review of the literature was conducted. Data sources Electronic databases (Medline, PsycInfo, ISI Web of knowledge, CINAHL and EMBASE), article reference lists, patient safety websites, registered study databases and author contacts. Eligibility criteria Studies were included that reported data from primary research in secondary care aiming to identify the contributory factors to error or threats to patient safety. Results 1502 potential articles were identified. 95 papers (representing 83 studies) which met the inclusion criteria were included, and 1676 contributory factors extracted. Initial coding of contributory factors by two independent reviewers resulted in 20 domains (eg, team factors, supervision and leadership).
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and PharmacySummary Impact TypePoliticalResearch Subject Area(s)Medical and Health Sciences:Public Health and Health ServicesDownload original PDFView similar case studiesSummary of the impact University of Bradford research into medication error management has directly impacted upon policy and practice, informing changes to http://impact.ref.ac.uk/CaseStudies/CaseStudy.aspx?Id=43185 mitigate potential harm across the 49 children's hospice services in the UK. Implementation http://www.pharmaceutical-journal.com/news-and-analysis/news/reducing-medication-errors-2007/10005125.article of a research-informed medicines management toolkit co-produced by the Bradford team and Children's Hospices UK (now Together for Short Lives) resulted in hospices identifying key vulnerabilities and using guidance from the toolkit to make significant service improvements. This impact of this research has resulted in changes in both practice and behaviour by error reporting strengthening systems for error reporting including the analysis of contributory factors -- staff are now identifying more errors and near misses, consequently leading to a reduced risk to the children. Underpinning research The Bradford medicines management team included Gerry Armitage (Lecturer 2000-2005, Senior University Teacher 2005-2007, Senior Lecturer 2008-2012, Professor 2012-present), Rob Newell (Professor 2001-2011), Kay Marshall (Senior Lecturer 1997-2007, Professor 2007-2013), and Mrs Jennifer drug error reporting Adams (Lecturer 2003-present). The research started in 2004 with the award of a Department of Health Research Development Award (2004-7) to Armitage, and continues to the present. Armitage conducted a programme of work investigating contributory factors in medication errors and strategies for increasing reporting and learning from errors (1,2,3). There is a considerable literature on the need to improve medical error reporting so as to advance organisational learning -- a central imperative in improving patient safety. Empirical work conducted by Armitage, and supported by Newell and Wright involved: the documentary analysis of 1250 incident reports; a systematic review of the contributory factors in medication error, and 40 in-depth interviews with a multi-disciplinary sample of practitioners who had been involved in medication errors. The research identified key vulnerabilities in the medicines management pathway and ways in which error reporting systems could be strengthened using design and structure to enable more effective analysis of causes and, in turn, increase organisational learning. A novel medication error reporting scheme with accompanying guidance was then designed. Following this, the process of error management was examined in a study with one of Armitage's external PhD students (Sirriyeh) in the
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