Error Diary

On Friday I found a great website called error diary which I wanted to share on here because I really love the idea behind it. The aim of this website is to get people talking about the everyday errors that we all make so that we can start to think about errors in a new way,  instead of just beating ourselves up about them and not learning from them.  I also thought it might be of interest to those lucky people who are taking part in our research, other pharmacists and anyone interested in this area of research.

You can read all about the origins of error diary on the website, but from what I can gather it was created by some researchers at University College London – in particular, Dr Dominic Furniss. The website is supported by a grant from the EPSRC (the Engineering and Physical Sciences Research Council) – this same grant also supports a huge study called CHI+MED which is looking at human error in the context of healthcare professionals’ interactions with medical devices (e.g. medicine pumps).

I should point out here that the pharmacy world is clearly aware of the work that the CHI+MED research team are carrying out because Prof Harold Thimbleby one of the members of the CHI+MED management team was presenting at the Royal Pharmaceutical Society Medicines Safety Symposium today in London. I am hoping this means that he will have inspired lots more research into human error and pharmacy systems.

Errordiary.org also has a page dedicated to resilience strategies. Those things we do to help us avoid making the same error time and time again. I have developed quite a few resilience strategies whilst running our experiments, to stop me forgetting to do or say  something. I have a script that I read from when I am briefing our participants (in fairness this is just best practice for anyone running experimental studies with human participants). I also have a post-it note with all the things I need to remember to do when running the study that sits on my computer desktop (on one of those electronic post-its that you can get on windows 7). It is very useful especially because I often run two participants at the same time which can open up lots of opportunities for errors to occur. One thing the errordiary website has inspired me to do is start noting down (with their permission) all the resilience strategies that my participants tell me about in their debrief. All those things they do on a day-to-day basis in their dispensary to avoid making an error – I am also going to write my own down as and when I notice them occurring.

Now that I have found these great sites and the CHI+MED project, I am sure I will be writing more about their work in future posts.

Image source: errordiary.org

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PTECO funding

Last year around July time Jane, Marjorie and I submitted an application for funding to the Pharmaceutical Trust for Educational and Charitable Objects . We did this because we wanted to be able to recruit community pharmacists to take part in our study because of the impact that expertise, knowledge of and practice of a task has a huge impact on the amount of mental workload experienced when that task is being carried out. Our study takes about 1 hour 30 minutes for participants to complete and so we knew that without this funding we would be asking an awful lot of pharmacies and community pharmacists.

We are very pleased to announce that we were successful in our application for funding from PTECO. This means that we will be able to reimburse pharmacies for the cost of providing locum cover whilst their community pharmacists take part in our study. It is still up to the individual pharmacist whether they would or wouldn’t like to take part, but thanks to PTECO, the pharmacists who would like to take part, can take part during their normal working day and not use one of their precious annual leave days to take part.  

As a young researcher I am very grateful for this opportunity that PTECO have given us and we are hopeful that by working with PTECO that the results will make an impact on pharmacy practice through the promotion of the results through PTECO’s networks.

So as you can see very exciting times are ahead for this project!

You can also read more about this funding on the University of Bath news page and in the January edition of Professional Matters from the Pharmaceutical Journal.

RPS Responsible Pharmacist Symposium 26/01/2012

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Jane and I were invited to the Royal Pharmaceutical Society (RPS) in London to attend a symposium about the responsible pharmacist regulations. It was organised by Martin Astbury (President of the RPS) and his colleagues and chaired by Catherine Duggan, Director of Professional Development and Support at the RPS. Both Jane and I were very excited to be invited and the day was even more interesting than the programme had promised. Originally billed as a discussion of the responsible pharmacist regulations it quickly led into discussions about the idea of developing a just culture in pharmacy.

In proposing this idea Martin Astbury and Catherine Duggan are breaking new ground in pharmacy practice as discussions in the literature have focused on a more general definition of safety culture. They also invited representatives from other industries e.g. Sean Parker from the Civil Aviation Authority to talk about how the just culture works in the aviation industry. Sean spoke about how the aerospace industry has been working towards a “just culture” and about their successes and failures in terms of safety management. This was very exciting for Jane and I as our mental workload research is based on research from the aerospace industry and we feel that there is a lot of ideas and measures that can be applied in pharmacy practice. What a relief to know that we have been working along the correct lines the last couple of years and that the professional body as a whole is now also considering what can be learnt from this industry.

For me, as a young researcher to be able to meet so many big names in the pharmacy practice world was very exciting. I have yet to perfect my networking skills so I was also very nervous the whole day, but the other conference delegates kindly listened to my ideas and thoughts when we broke up into small groups to discuss how a just culture could work for pharmacy. There were many great view points and it was clear that each sector of pharmacy perceived different barriers to the development of this culture. The overall biggest one was how pharmacy sits within the wider health care services, and is it possible for pharmacy to develop a new culture when they are also embedded in the culture of the NHS and their respective trusts, or communities?

Overall for me, I was just thrilled to be invited to the very first discussion and meeting about this potential shift in pharmacy culture, especially as it fits so nicely with our research. There will be a lot more work and discussion within the profession before anything is decided or done, so I will keep updating this page with news and information as I get it.

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