The purpose of this study was to qualitatively describe the medication process in the hospital-affiliated outpatient.
Methods:
A qualitative descriptive design with semi-structured interview a purposeful sampling was used to gain a rich understanding of physicians’, nurses’, and pharmacists’ current roles, work, and perceptions in medication process in the outpatient from July 2017 to September 2017. In total, 15 face-to-face interviews, including 5 physicians, 5 nurses, and 5 pharmacists, were interviewed. The inclusion criteria including that work in the outpatients 3 months and longer.
Results:
Medication process in outpatients is very different than in the inpatient. Themes elicited were categorized into the domains of (1) professionalism, (2) communication gaps, (3) heavy workload, (4) informative technology, (5) hospital administration, and (6) patient’s involvement. Due to the lack of medication reconciliation training, the role of nurses in outpatient medication process is not clear. Even doctors might identify some medication issues; they are hesitated to change the medication regimen if they are not the prescribing doctors. How to communicate changes or suggestions for medication regimens is unknown in outpatients. Due to the heavy workload, doctors and pharmacists don’t have to much time to review complex medication history and regimen. Informative technology (IT) is designed to help professionals to be more efficiently to reconcile medication regimens, but IT sometimes contain too much information and slow the access time and thus doesn’t help that much in the medication process in the outpatient. Patients have a more important role in medication process in outpatient than in inpatient. They need to understand their medications so they can provide accurate medication information to their doctors and they need to become their own messenger to bring information among doctors. Those domains helped us to understand threats and areas to work in order to enhance medication safety in outpatient.
Conclusion:
Medication process is very fragmented and has been overlooked in the outpatients. Specialists have advantage in providing care for specific diseases but are balanced by disadvantages of insufficient interprofessional communication and incomprehensive medication process. The collaboration of physicians, nurses, pharmacists, and patients with the integration of informative technology might be the potential solution in enhancing the safety of medication process in outpatients.