GP receptionists help safeguard patients in repeat prescribing, finds study
ScienceDaily (Nov. 3, 2011) Receptionists and administrative staff in UK general practices make important ‘hidden’ contributions to repeat prescribing, concludes a study published on bmj.com.
It finds that over-reliance on electronic health records can affect the quality and safety of repeat prescribing, but that reception staff often use “practical judgments” to help bridge the gap between formal prescribing protocols and the complex reality of the repeat prescribing process.
The findings highlight the need to ensure that training in repeat prescribing goes beyond technology to help safeguard patients, state the authors.
Repeat prescriptions account for up to three quarters of all medication prescribed and four fifths of medication costs in UK general practice and repeat prescribing has long been recognised as a significant quality and safety concern.
It is often assumed that electronic records make repeat prescribing safer by reducing human error. However, some suggest it may introduce technology-related errors.
So researchers at Queen Mary, University of London analysed how doctors, receptionists and other administrative staff contributed to, and collaborated on, repeat prescribing routines at four UK general practices.
The aim was to identify potential threats to patient safety and characteristics of good practice.
They also found that a “model-reality gap” exists between formal prescribing protocols and the real time activity of repeat prescribing, but that staff often bridge this gap by making “practical judgments” which helped to safeguard patients.
This work was creative and demanded both explicit and tacit knowledge, even though clinicians were often unaware of this input, state the authors.
In conclusion, reception and administrative staff make important ‘hidden’ contributions to repeat prescribing in general practice, they write. Although not formally accountable for prescriptions signed by doctors, they think about themselves informally accountable to patients for the quality and safety of these contributions.
“It seems reasonable to encourage well trained receptionists to use their initiative in repeat prescribing, but practices need to ensure that members of staff do not step beyond their levels of knowledge and competence,” writes Professor Anthony Avery from the University of Nottingham Medical School in an accompanying editorial.
There is tiny evidence that the high levels of autonomy and engagement shown by some receptionists is a cause for concern, he adds. Nevertheless errors do occur in the repeat prescribing process and he calls for further research to find out why.
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The above story is reprinted from materials provided by BMJ-British Medical Journal.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
D. Swinglehurst, T. Greenhalgh, J. Russell, M. Myall. Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study. BMJ, 2011; 343 (nov03 2): d6788 DOI: 10.1136/bmj.d6788A. J. Avery. Repeat prescribing in general practice. BMJ, 2011; 343 (nov03 2): d7089 DOI: 10.1136/bmj.d7089
Note: If no author is given, the source is cited instead.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.
source : www.sciencedaily.com
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Submited at Friday, November 4th, 2011 at 7:00 am on Health by chuck
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