Primary Health Care Errors Study: Qualification And Quantification Of Errors Occurring In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$191,000.00
Summary
The General Practice Errors Study (GPES) is a project that aims to examine errors that GPs notice in their daily practice, that affect patient well-being or care. Very little work has been done on this subject in General Practice in any other country, and Australia is the only country with previous research that has attempted to describe GP errors with the Quality in Australia Health Care Study (QAHCS). However, we have so far not had any research that has been done on a representative sample of ....The General Practice Errors Study (GPES) is a project that aims to examine errors that GPs notice in their daily practice, that affect patient well-being or care. Very little work has been done on this subject in General Practice in any other country, and Australia is the only country with previous research that has attempted to describe GP errors with the Quality in Australia Health Care Study (QAHCS). However, we have so far not had any research that has been done on a representative sample of GPs, or been able to quantify the frequency with which different types of errors occur. This study plans to ask a representative sample of GPs in both urban and rural areas to report their errors, so that we can try to quantify the incidence and prevalence of these different error types. No previous work has been done in Primary care which has attempted to determine the rate of recognized errors that occur in the community. In addition, since the last major work on this topic was done between 1993 and 1998, there have been many changes to General Practice, especially in the area of computerisation, and the types of problems that GPs face now may have changed significantly. Anonymous reporting is very important in order to encourage health professionals to admit to their mistakes, and in the past, projects have used paper based reporting forms, making it difficult to offer anonymity and requiring protection for participants under a Commonwealth Act of Parliament. However the GPES project will be the first major study of General Practice errors that uses an on-line anonymous reporting form, and high level encryption, located on a secure web-site, to encourage honest reporting. The reporting form was trialled in the 2001 pilot study. By analysing the types of errors occurring, and their contributing factors, we can target at-risk population groups and develop strategies to improve patient care and prevent future harm.Read moreRead less
The Safety And Effectiveness Of Hospital E-prescribing Systems: A Controlled Time Series Study
Funder
National Health and Medical Research Council
Funding Amount
$740,460.00
Summary
Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are b ....Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are believed to significantly reduce the number of errors which occur and reduce harm to patients as a result. No studies have demonstrated that these systems result in reducing prescribing errors that cause harm to patients. Alarmingly, anecdotal evidence from overseas suggests that use of electronic prescribing systems introduces new types of errors. This is consistent with a growing body of scientific research which suggests that individuals' decision-making may be significantly influenced by information generated by a computer, resulting in new types of errors. The aim of this project is to undertake a controlled time series study to assess the safety and effectiveness of two electronic prescribing systems to reduce prescribing errors in Australian hospitals. The study will compare error rates before and after the introduction of the systems. In addition, the study will be the first to focus on measuring new types of errors that may result from system use and to investigate how computer use influences clinicians' decision-making. This study will provide critical information about the effectiveness and safety of these systems which are being introduced into Australian hospitals. Unlike other medical interventions, which require stringent safety testing before use with patients, there are no minimum safety requirements for electronic prescribing systems. The data from this study is urgent in developing recommendations to ensure the safety of electronic prescribing systems for Australia.Read moreRead less
The Impact Of Electronic Medication Administration Records (e-MAR) On Medication Administration Safety And Nurses' Work
Funder
National Health and Medical Research Council
Funding Amount
$735,675.00
Summary
The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potenti ....The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.Read moreRead less
EVALUATION OF THE EFFECTIVENESS OF EXPANDED NEWBORN SCREENING BY TANDEM MASS SPECTROMETRY
Funder
National Health and Medical Research Council
Funding Amount
$375,250.00
Summary
Newborn babies in Australia are routinely tested for certain treatable disorders. Testing began in the 1960's with systematic testing for phenylketonuria, a rare amino acid enzyme defect. It causes severe mental retardation which can only be prevented if treatment is begun in the first few weeks of life. By 1997, only three other disorders, congenital hypothyroidism, cystic fibrosis, and galactosaemia, had been added to the testing protocol as tests became available. Using the new technology of ....Newborn babies in Australia are routinely tested for certain treatable disorders. Testing began in the 1960's with systematic testing for phenylketonuria, a rare amino acid enzyme defect. It causes severe mental retardation which can only be prevented if treatment is begun in the first few weeks of life. By 1997, only three other disorders, congenital hypothyroidism, cystic fibrosis, and galactosaemia, had been added to the testing protocol as tests became available. Using the new technology of tandem mass spectrometry (MSMS) it is now possible to screen for up to 30 extremely rare, treatable metabolic disorders simultaneously and cheaply, but it is not clear how effective this is. A formal trial of MSMS screening, randomly assigning babies to be tested or not tested, does not seem feasible because of the rarity of the individual disorders (most with a birth prevalence much less than 1: 50,000). Huge numbers would be needed in the trial for statistical significance. We began MSMS screening in NSW April 1998 and in South Australia in February 1999. Victoria is proposing to start screening now, but there are as yet no plans for this screening in the other states. We would like to assess the effectiveness of MSMS newborn screening using the best possible evidence drawn from all data available in the whole of Australia. We plan to undertake an economic evaluation, comparing costs and benefits such as development, hospitalisations, medical complications and other outcome measures, in screened and unscreened babies and also assess harms from screening. Because only 6 specialised laboratories in Australia, in Brisbane (2), Sydney, Melbourne, Adelaide, and Perth can diagnose these disorders, we are confident that we know of all diagnosed cases of the disorders in question. We hope to be able to show whether or not there is a benefit to affected babies by implementing newborn screening tests for these rare diseases.Read moreRead less