Drug, Healthcare and Patient Safety (May 2022)
Obstacles and Opportunities in Information Transfer Regarding Medications at Discharge – A Focus Group Study with Hospital Physicians
Abstract
Maria Glans,1,2 Patrik Midlöv,1 Annika Kragh Ekstam,3 Åsa Bondesson,1,4 Annika Brorsson1 1Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Clinical Research Center, Malmö, 20213, Sweden; 2Department of Medications, Kristianstad-Hässleholm Hospitals, Kristianstad, Sweden; 3Department of Orthopedics, Kristianstad-Hässleholm Hospitals, Kristianstad, Sweden; 4Department of Medicines Management and Informatics in Skåne County, Region Skåne, Kristianstad, SwedenCorrespondence: Maria Glans, Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Clinical Research Center, Box 50332, Malmö, 20213, Sweden, Tel +46-44-3092971, Email [email protected]: This qualitative study aimed to investigate experiences and perceptions of hospital physicians regarding the discharging process, focusing on information transfer regarding medications.Methods: By purposive sampling three focus groups were formed. To facilitate discussions and maintain consistency, a semi-structured interview guide was used. Discussions were audio recorded and transcribed verbatim. Qualitative content analysis was used to analyze the anonymized data. A confirmatory analysis concluded that the main findings were supported by data.Results: Identified obstacles were divided into three categories with two sub-categories each: Infrastructure; IT-systems currently used are suboptimal and complex. Hospital and primary care use different electronic medical records, complicating matters. The work organization is not helping with time scarcity and lack of continuity. Distinct routines could help create continuity but are not always in place, known, and/or followed. Physician: knowledge and education in the systems is not always provided nor prioritized. Understanding the consequences of not following routines and taking responsibility regarding the medications list is important. Not everyone has the self-reliance or willingness to do so. Patient/next of kin: For patients to provide information on medications used is not always easy when hospitalized. Understanding information provided can be hard, especially when medical jargon is used and there is no one available to provide support. A central theme, “We’re only human”, encompasses how physicians do their best despite difficult conditions.Conclusion: There are several obstacles in transferring information regarding medications at discharge. Issues regarding infrastructure are seldom possible for the individual physician to influence. However, several issues raised by the participating physicians are possible to act upon. In doing so medication errors in care transitions might decrease and information transfer at discharge might improve.Keywords: focus groups, medication reconciliation, medication errors, health information exchange, patient discharge summaries, patient discharge
