A qualitative study exploring how routinely collected Medication Safety Thermometer data have been used for quality improvement purposes using case studies from three UK hospitals

Objectives

The Medication Safety Thermometer (MedsST) is a medication safety data collection tool, which has been used by over 100 UK healthcare organisations to enable measurement of medication safety for improvement purposes. This study aimed to explore whether, and how, data collected by the MedsST have been used in organisations to facilitate medication safety improvements.

Design

Routine MedsST data collected between October 2013 and July 2016 were analysed using Run charts. Identified changes were investigated using interviews with staff from each hospital trust. The interviews were analysed using a framework based on Normalisation Process Theory, focusing on use of the MedsST and its data.

Setting

Three National Health Service hospital trusts in the North West of England, which have used the MedsST for the longest period.

Participants

Eight interview participants, purposely sampled based on their involvement with the MedsST, included pharmacists, pharmacy technicians and nurses.

Results

Improvement was often at ward level and focused on particular areas of medication safety, led by clinical champions. The most sustainable improvements involved changes to systems, such as introducing new guidelines. Although some improvement occurred, internal communication about improvements was poor, and large amounts of data remained unused, often due to a lack of ownership of data review and use.

Conclusions

Simply collecting data is not sufficient; a system of data collection, review and use for improvement is required. Issues with such systems may have been recognised and averted if implementation theory had been used in the early stages of national development and implementation. However, implementation theory could be used within organisations to fix issues locally, particularly to increase ward-level ownership of this system, which could lead to considerable improvements.

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