Medication errors in hospitals are a large and increasing problem, which has traditionally been considered a result of human error. Recent attempts to reduce errors have emphasised systems approaches and improvements in information and communications technologies (ICT). As part of a multi-method evaluation project for hospital point of care clinical systems, we assembled a team of professionals from a variety of clinical, information management, health management, sociology, linguistics and engineering backgrounds. We built a systems simulation for explicitly representing the interactions among the key determinants of medication errors. These included the complex interactions of patients and staff, information, medications, work practices and the infrastructure and policies within a hospital environment.
Our team simulated hospital inpatient and staff flow, generation and interception of medication errors, and the potential impacts of ICT-enabled work practice changes. This paper describes the System Dynamics Model of long-term context that produces errors in the medication management process. Future extensions include the use of a combined agent based and SD simulation to produce a multi-method, multi-level systems simulation testbed as an integrating framework for evaluating combinations of improvement interventions.
KEYWORDS: health systems simulation, medication error, information and communications technology, multi-method evaluation