Impact of an electronic medication management system on hospital doctors' and nurses' work

A controlled pre-post, time and motion study

Johanna I. Westbrook*, Ling Li, Andrew Georgiou, Richard Paoloni, John Cullen

*Corresponding author for this work

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Objective To quantify and compare the time doctors and nurses spent on direct patient care, medicationrelated tasks, and interactions before and after electronic medication management system (eMMS) introduction. Methods Controlled pre-post, time and motion study of 129 doctors and nurses for 633.2 h on four wards in a 400-bed hospital in Sydney, Australia. We measured changes in proportions of time on tasks and interactions by period, intervention/control group, and profession. Results eMMS was associated with no significant change in proportions of time spent on direct care or medication-related tasks relative to control wards. In the post-period control ward, doctors spent 19.7% (2 h/10 h shift) of their time on direct care and 7.4% (44.4 min/ 10 h shift) on medication tasks, compared to intervention ward doctors (25.7% (2.6 h/shift; p=0.08) and 8.5% (51 min/shift; p=0.40), respectively). Control ward nurses in the post-period spent 22.1% (1.9 h/8.5 h shift) of their time on direct care and 23.7% on medication tasks compared to intervention ward nurses (26.1% (2.2 h/shift; p=0.23) and 22.6% (1.9 h/shift; p=0.28), respectively). We found intervention ward doctors spent less time alone (p=0.0003) and more time with other doctors (p=0.003) and patients (p=0.009). Nurses on the intervention wards spent less time with doctors following eMMS introduction (p=0.0001). Conclusions eMMS introduction did not result in redistribution of time away from direct care or towards medication tasks. Work patterns observed on these intervention wards were associated with previously reported significant reductions in prescribing error rates relative to the control wards.

Original languageEnglish
Pages (from-to)1150-1158
Number of pages9
JournalJournal of the American Medical Informatics Association
Volume20
Issue number6
DOIs
Publication statusPublished - 2013
Externally publishedYes

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