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Impact of A Systems - Centred Intervention For Reducing Repeat Prescribing Risks In A Large Primary Care Organisation

Abstract :
Background and aims :- Repeat prescribing of medications is a high volume general practice activity that carries significant patient safety risk. Building on previous work to design and test an online systems-based risk management model to identify and measure repeat prescribing hazards, we aimed to advise and support practices to implement recommended improvement actions, with the target goal to reduce baseline risk rating profile scores by 80%.

Methods:- Multiple methods were utilised including use of a web-based risk assessment system, application of a risk rating scoring process, external review visits and follow-up visit or telephone support calls by experienced, independent Medical Protection risk professionals who made multiple improvement recommendations and provided related implementation advice to local practices.

Results:- 45/48 practices in a large primary care organisation participated (93.8%), with 40 (88.9%) achieving the target goal of reducing their risk rating score by 80% or greater. The aggregated mean risk rating profile score reduced from 1781.8 (range: 405 to 3890; SD= 907.2) to 146.6 (range: 0 to 1290; SD=255.0). 26 practice teams (57.8%) were able to comply with 100% of the improvement actions recommended, with a further 12 (26.7%) complying with 80.0 to 99.5% of recommendations. Overall the mean percentage of recommended actions implemented was 88.8% (range: 0 to 100%; SD=20.5).

Conclusion:- The combined web-based benchmarking system and risk management method employed have potential to drive safety improvements in repeat prescribing systems at local practice and primary care organisational levels. The improvement approach described will be of strong interest to primary care organisations internationally as part of evolving patient safety priorities


Julie Price, Diane Baylis, Kate Taylor, Matthew Mason, Vanessa Burgess, Shu Ling Man & Paul Bowie

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