JMIR Publications

ABSTRACT

Background:

Medication incidents (MIs) causing patient harm hold far-reaching consequences for patients, pharmacists, public health, business practice and governance policy. Medication Incident Reporting and Learning Systems (MIRLS) have been implemented to mitigate such incidents and promote continuous quality improvement programs for Community Pharmacies in Canada. Such systems aim to collect and analyze MIs for the development and implementation of incident preventive strategies that will increase safety in community pharmacy practice. This goal remains inhibited due to persistent barriers pharmacies face when using these systems. Identified critical barriers include time constraints, voluntary readiness to complete MI reporting, and lack of perceived value of the systems.

Objective:

The present research seeks to identify and propose persuasive and motivational design strategies to motivate pharmacists and the pharmacy team to increase reporting and enhance the usability of existing reporting and learning systems.

Methods:

We analyzed one of the most widely used medication incident reporting and learning systems in Canada (Think Research/Pharmapod’s Incident Management and Learning System) using the Persuasive Systems Design Model – a framework for analyzing, designing, implementing, and evaluating persuasive systems. It entails the application of behavioral theories from social psychology in the design of technology-based systems to motivate behavior change. Independent assessors familiar with the MIRLS reported the degree of persuasion built into the system using the Oinas-Kukkonen and Harjumaa (15) categories of four functional groups (primary task support, dialogue support, social support, and system credibility support), each of which comprises seven persuasive strategies.

Results:

We found that the studied medication incident reporting and learning system already supports a number of persuasive design strategies suggested by the design model; however, we identified additional motivational and persuasive design strategies such as tunneling, simulation, suggestion, praise, reward, reminder, authority, and verifiability that could further enhance the usability of the system and perceived value of medication incident reporting. We discuss these strategies and implications for practice.

Conclusions:

Medication incident reporting and learning systems, such as Think Research/Pharmapod, can become powerful persuasive tools to promote the culture of safety and safer medication practices in community pharmacies. To enhance such systems, we proposed implementing the design of persuasive system strategies to address the critical barriers preventing the reporting of all incidents and near miss events, increase the voluntary readiness to report incidents, and to show the value of medication incident reporting. These strategies serve as guidelines for designers and developers of MIRLS as well as for community pharmacy managers implementing effective quality improvement practices.