Medication Safety

UT Arlington Faculty: Yan Xiao, Kathryn Daniel, Jing Wang, Kay-Yut Chen, Yuan Zhou

Collaborators: Kimberly Fulda, Richard Young, Ayse Gurses

Ph.D. Students: Amith Viswanatha

Funding: Agency for Healthcare and Research Quality (2019-20)

Topic: PROMIS Learning Lab for medical safety.

Description: This project develops a learning laboratory for patient safety in primary care. The Partnership in Resilience for Medication Safety Learning Lab (PROMIS Lab) redesigns primary care work system to address multiple types of medication related harms among older adults through collaborating with clinics and patients, especially those in low socio-economic status. Our innovative approaches are focused on achieving productive interactions between primary care professionals and patients/home caregivers, which are fundamental to medication safety. Preventable patient harms from medications are significant threats to patient safety in ambulatory and community settings, with more than a third of community-dwelling older adults taking 5 or more prescription medications. In ambulatory and community settings, more so than in inpatient settings, medication safety is shaped by interactions among patient/family and different professionals across locations. Primary care professionals are in a unique position to partner with patients and community caregivers to reduce risks of medication-related preventable harms, such as polypharmacy and inaccurate medication information, and to cope with setbacks and disturbances that threaten safety. The PROMIS Lab is designed to broadly explore the problem and solution space, with (1) “in-situ lab” clinics from a practice-based research network for study, design and evaluation, (2) community partners to include extensively older adults and their caregivers, (3) a network of clinics for observations and learning, and (4) a simulated outpatient care suite for design mockups and evaluation. We will engage advisors with expertise in patient safety advocacy, deprescribing, ambulatory medication safetWe leverage the synergy of multiple engineering and healthcare disciplines to bring to bear the concepts and methods in human factors and systems engineering, primary care delivery, family medicine, nursing, pharmacy, health services research, behavioral economics and healthcare architecture through cycles of problem analysis, design, rapid prototyping, and evaluation in simulated and clinical settings. Aim #1. Identify and define primary care work system design requirements for safe medication use in ambulatory and community settings to address commonly occurring medication related hazards and to enhance resilience through partnership. Aim #2. Design, develop, and test solutions of work system redesign, such as informational tools, task redesign, and space layout, to enable and build capacity for resilient actions. Aim #3. Implement and evaluate work system components for medication safety partnership at 2 primary care clinics. The PROMIS Lab’s long term impact will be insights and innovative tools, design guidelines, and educational materials for patient safety improvement through engineering a foundation for partnership. We will engage with older adults and primary care professionals throughout design cycles. The Lab has all necessary ingredients for sustainable design, development and evaluation efforts through transdisciplinary research to address complex changes of patient safety in ambulatory and community settings.