Investigating the requirements for secondary use of data to drive improvement in the quality and safety of medication use
File(s)
Author(s)
Chaudhry, Navila Talib
Type
Thesis
Abstract
The increase in implementation of electronic prescribing (EP) systems in secondary care and the use of electronic hospital pharmacy (EHP) systems provide considerable opportunities for reusing routinely collected data to support quality improvement work around medication safety. In previous literature, secondary use of data (SUD) has been explored in a fragmentary manner and considerable scope existed for applied research to guide users and developers in this area.
This PhD sought to address those gaps by employing mixed methods and the aims were to investigate SUD requirements for effective quality monitoring and feedback processes to ensure improvement in the quality and safety of medication use, and to enhance the value of EP and EHP systems for users.
This PhD provides a systematic narrative review on the current evidence base available on SUD interventions in practice. Mixed methods were used to expand upon the process of SUD, the factors influencing it, the current reuses of data in practice, how individuals define SUD, and the reasons and types of data currently being reused from EP and/or EHP systems within England. There were complexities in defining SUD; however, a definition was formed by collating the previous evidence base with the qualitative findings of this PhD. The national survey revealed various cases of SUD and that a time lag existed between EP implementation and SUD. The mixed methods identified different levels of SUD that existed: reuse of data to identify a gap for improvement, reuse of data to evaluate interventions, and reuse of data driving improvement (as an intervention).
The findings of the empirical work within this PhD built upon one another to produce and validate a SUD framework that allows: stakeholders to enhance application of SUD locally in secondary care, to enhance transparency of SUD interventions, and overcome barriers and consider factors influencing SUD.
This PhD sought to address those gaps by employing mixed methods and the aims were to investigate SUD requirements for effective quality monitoring and feedback processes to ensure improvement in the quality and safety of medication use, and to enhance the value of EP and EHP systems for users.
This PhD provides a systematic narrative review on the current evidence base available on SUD interventions in practice. Mixed methods were used to expand upon the process of SUD, the factors influencing it, the current reuses of data in practice, how individuals define SUD, and the reasons and types of data currently being reused from EP and/or EHP systems within England. There were complexities in defining SUD; however, a definition was formed by collating the previous evidence base with the qualitative findings of this PhD. The national survey revealed various cases of SUD and that a time lag existed between EP implementation and SUD. The mixed methods identified different levels of SUD that existed: reuse of data to identify a gap for improvement, reuse of data to evaluate interventions, and reuse of data driving improvement (as an intervention).
The findings of the empirical work within this PhD built upon one another to produce and validate a SUD framework that allows: stakeholders to enhance application of SUD locally in secondary care, to enhance transparency of SUD interventions, and overcome barriers and consider factors influencing SUD.
Version
Open Access
Date Issued
2016-12
Date Awarded
2017-07
Copyright Statement
Attribution NoDerivatives 4.0 International Licence (CC BY-ND)
Advisor
Benn, Jonathan
Dean Franklin, Bryony
Sponsor
Health Foundation (Great Britain)
Imperial College London
Grant Number
WSSS-PS7480
Publisher Department
Department of Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)