Int J Med Inform - Prescribers' interactions with medication alerts at the point of prescribing: A multi-method, in situ investigation of the human-computer interaction.

Tópicos

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Resumo

RPOSE: Few studies have examined prescribers' interactions with medication alerts at the point of prescribing. We conducted an in situ, human factors investigation of outpatient prescribing to uncover factors that influence the prescriber-alert interaction and identify strategies to improve alert design.METHODS: Field observations and interviews were conducted with outpatient prescribers at a major Veterans Affairs Medical Center. Physicians, clinical pharmacists, and nurse practitioners were recruited across five primary care clinics and eight specialty clinics. Prescribers were observed in situ as they ordered medications for patients and resolved alerts. Researchers collected 351 pages of typed notes across 102 hours of observations and interviews. An interdisciplinary team identified emergent themes via inductive qualitative analysis.RESULTS: Altogether, 320 alerts were observed among 30 prescribers and their interactions with 146 patients. Qualitative analysis uncovered 44 emergent themes and 9 overarching factors, which were organized into a framework that describes the prescriber-alert interaction. Prescribers' ability to act on alerts was impeded by the alert interface, which did not adequately support all prescriber types.CONCLUSIONS: This empiric study produced a novel framework for understanding the prescriber-alert interaction. Results revealed key components of the alert interface that influence prescribers and indicate a need for more universal design. Actionable design recommendations are presented and may be used to enhance alert design and patient safety.

Resumo Limpo

rpose studi examin prescrib interact medic alert point prescrib conduct situ human factor investig outpati prescrib uncov factor influenc prescriberalert interact identifi strategi improv alert designmethod field observ interview conduct outpati prescrib major veteran affair medic center physician clinic pharmacist nurs practition recruit across five primari care clinic eight specialti clinic prescrib observ situ order medic patient resolv alert research collect page type note across hour observ interview interdisciplinari team identifi emerg theme via induct qualit analysisresult altogeth alert observ among prescrib interact patient qualit analysi uncov emerg theme overarch factor organ framework describ prescriberalert interact prescrib abil act alert imped alert interfac adequ support prescrib typesconclus empir studi produc novel framework understand prescriberalert interact result reveal key compon alert interfac influenc prescrib indic need univers design action design recommend present may use enhanc alert design patient safeti

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