MindSElS · Resilience, Mindfulness and Medication Safety with Electronic Systems

Resilience, Mindfulness and Medication Safety with Electronic Systems

Medication safety is one of the most serious concerns for patient safety across all healthcare sectors, and one of the most challenging to address. The complexity of healthcare delivery calls for an approach to medication safety that builds on learning from ‘everyday resilience’, and one way to achieve organisational resilience is through mindful organising. In particular, five dimensions have been identified in high-reliability organisations contributing to resilience, reliability and safety, in aggregate known as ‘collective mindfulness’: preoccupation with failure, reluctance to simplify, sensitivity to operations, commitment to resilience, and deference to expertise [1]. Electronic medication management systems are being introduced in hospitals worldwide with the aim of improving medication safety. However, there is evidence of negative consequences and technology design and implementation may undermine the potential for resilience and therefore affect an organisation’s capacity for collective mindfulness. Research on the consequences of introducing electronic medication management systems for collective mindfulness is limited and fragmented. Resilience, Mindfulness and Medication Safety with Electronic Systems (MindSElS) is a Marie Skłodowska-Curie Global Individual Fellowship awarded to Dr Valentina Lichtner (‘the fellow’). It is a collaboration with UCL School of Pharmacy (University College London, UK) and the Centre for Health Systems and Safety Research (CHSSR) at the Australian Institute of Health Innovation (AIHI, Macquarie University, Sydney, Australia). The MindSElS project aims to improve medication safety in hospital inpatients by: - developing theory and method for evaluation of individual and collective mindfulness associated with electronic medication management systems; - investigating whether and how this technology can support organisational resilience in the use of medications; - providing guidance for technology implementation aimed at achieving and sustaining resilience. To address these aims, we propose [2] a framework of six research questions (Q) underpinned by sociotechnical assumptions and human factors understanding of technology in the workplace. For this project, we focused on Q1-Q3 applied to medication: Q1. How does mindfulness manifest in medication work practices? Q2. Does the current sociotechnical system support mindfulness? What role do existing tools have on staff ‘rescuing’ potential patient safety near misses? Q3. How do practices change with the implementation of heath IT? What role has the new technology on maintaining mindfulness? References 1. Sutcliffe and Weick, Mindful Organising and Resilient Healthcare, in: Resilient Health Care, 2013, Ashgate: London.145-156. 2. Lichtner, Franklin, and Westbrook. Stud Health Technol Inform, 2019. 265:31-36.

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