Improving feedback on junior doctors’ prescribing errors: mixed methods evaluation of a quality improvement project

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Title: Improving feedback on junior doctors’ prescribing errors: mixed methods evaluation of a quality improvement project
Authors: Reynolds, M
Jheeta, S
Benn, J
Sanghera, I
Jacklin, A
Ingle, D
Franklin, BD
Item Type: Journal Article
Abstract: Background Prescribing errors occur in up to 15% of UK inpatient medication orders. However, junior doctors report insufficient feedback on errors. A barrier preventing feedback is that individual prescribers often cannot be clearly identified on prescribing documentation. Aim To reduce prescribing errors in a UK hospital by improving feedback on prescribing errors. Interventions We developed three linked interventions using plan*do*study*act cycles: (1) name*stamps for junior doctors who were encouraged to stamp or write their name clearly when prescribing; (2) principles of effective feedback to support pharmacists to feed back to doctors on individual prescribing errors; (3) fortnightly prescribing advice emails that addressed a common and/or serious error. Implementation and evaluation Interventions were introduced at one hospital site in August 2013 with a second acting as control. Process measures included the percentage of inpatient medication orders for which junior doctor s stated their name. Outcome measures were junior doctors’ and pharmacists’ perceptions of current feedback provision (evaluated using quantitative pre*post questionnaires and qualitative focus groups), and the prevalence of erroneous medication orders written by junior doctors between August and December 2013.
Issue Date: 4-Apr-2016
Date of Acceptance: 14-Mar-2016
ISSN: 2044-5423
Publisher: BMJ Publishing Group
Start Page: 240
End Page: 247
Journal / Book Title: BMJ Quality & Safety
Volume: 26
Copyright Statement: © 2017 The Authors. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:
Sponsor/Funder: Imperial College Healthcare NHS Trust
National Institute for Health Research (NIHR)
The Health Foundation
Funder's Grant Number: RDPSC 79560
RDPSC 79560
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
Audit and feedback
Medical education
Medication safety
Quality improvement
Publication Status: Published
Appears in Collections:Division of Surgery
Department of Medicine
Faculty of Medicine

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