Health Information Technology

Staff willingness to change and adapt is important when implementing electronic pharmacy systems

Electronic pharmacy systems can do much to improve patient safety and reduce medication errors in hospitals. Implementing these systems requires putting into place a number of facilitators as well as overcoming identified barriers. A new study points to the willingness of hospital employees to change and adapt to the system as factors critical to success.

These insights come from Children's Healthcare of Atlanta, a two-hospital pediatric health care system that began implementing an electronic pharmacy system in 2005. Information was gathered from pharmacists and clinical managers at approximately 3 months prior to the system being introduced and then again at 3 months after implementation. While interviewed pharmacists believed the system's implemen-tation would mainly affect pharmacists, clinical managers felt that frontline nurses and respiratory therapists would be most affected.

Both pharmacists and clinical managers generally agreed that the three main goals for implementation were to improve patient safety, increase job efficiency, and update the existing hospital system. Staff readiness-to-change was the most significant facilitator of adoption, according to the pharmacists. On the other hand, clinical managers identified system training and education as their most significant facilitator. Other identified facilitators included having an effective implementation plan and having a user-friendly, flexible system. Pharmacists cited the most important barrier as staff concerns with the usability of information in the pediatric drug file. Clinical managers, however, felt that adjusting to new work processes was the biggest barrier. Other barriers included staff apprehension and resistance, potential problems transferring active orders, and poor communication and feedback.

The researchers recommend that hospitals implementing an electronic pharmacy system consider training super users, providing formal feedback mechanisms, and understanding how implementation may affect various hospital staff groups differently. The study was supported in part by the Agency for Healthcare Research and Quality (HS15236).

See "Implementing a pharmacy system: Facilitators and barriers," by Steven D. Culler, Ph.D., James Jose, M.D., Susan Kohler, R.N., M.P.H., and others, in the Journal of Medical Systems 33, pp. 81-90, 2009.

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