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BACKGROUND Medication errors are common in primary care and are associated with considerable risk of patient harm. We tested whether a pharmacist-led, information technology-based intervention was more effective than simple feedback in reducing the number of patients at risk of measures related to hazardous prescribing and inadequate blood-test monitoring(More)
OBJECTIVE To evaluate whether a service to prevent falls in the community would help reduce the rate of falls in older people who call an emergency ambulance when they fall but are not taken to hospital. DESIGN Randomised controlled trial. SETTING Community covered by four primary care trusts, England. PARTICIPANTS 204 adults aged more than 60 living(More)
INTRODUCTION Prevention of medication errors is a priority for health services worldwide. Pharmacists routinely screen prescriptions for potential problems, including prescribing errors. This study describes prescribing problems reported by community pharmacists and discusses them from an error prevention perspective. METHOD For one month, nine community(More)
BACKGROUND Standard home care support for people with dementia has been criticised in statutory inspection reports, and may lead to unnecessary crises, hospital or care home admissions. OBJECTIVE To establish whether a specialist multiagency home care service for older people with dementia delivered better quality care than standard services, and how any(More)
Alerts and prompts represent promising types of decision support in electronic prescribing to tackle inadequacies in prescribing. A systematic review was conducted to evaluate the efficacy of computerized drug alerts and prompts searching EMBASE, CINHAL, MEDLINE, and PsychINFO up to May 2007. Studies assessing the impact of electronic alerts and prompts on(More)
The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research. Based on our experiences of conducting several health-related case studies, we reflect on the(More)
OBJECTIVES To describe and evaluate the implementation and adoption of detailed electronic health records in secondary care in England and thereby provide early feedback for the ongoing local and national rollout of the NHS Care Records Service. DESIGN A mixed methods, longitudinal, multisite, socio-technical case study. SETTING Five NHS acute hospital(More)
OBJECTIVE To assess the impact of a pay for performance incentive on quality of care and outcomes among UK patients with hypertension in primary care. DESIGN Interrupted time series. SETTING The Health Improvement Network (THIN) database, United Kingdom. PARTICIPANTS 470 725 patients with hypertension diagnosed between January 2000 and August 2007. (More)
The objective of this review is to describe the implementation of human factors principles for the design of alerts in clinical information systems. First, we conduct a review of alarm systems to identify human factors principles that are employed in the design and implementation of alerts. Second, we review the medical informatics literature to provide(More)
OBJECTIVES To evaluate the implementation and adoption of the NHS detailed care records service in "early adopter" hospitals in England. DESIGN Theoretically informed, longitudinal qualitative evaluation based on case studies. SETTING 12 "early adopter" NHS acute hospitals and specialist care settings studied over two and a half years. DATA SOURCES(More)