Patient-Driven Medication Safety Learning Laboratory in Care Transitions

This AHRQ-funded initiative aims to better understand barriers and facilitators to preventing, identifying, and resolving medication safety problems in transitions across levels of care within the healthcare system. We will utilize a combination of patient and caregiver surveys and interviews, workflow analyses, and insights from clinical data. Following data collection and synthesis, we will work with patients, providers, and staff from across the Erie County Medical Center (ECMC) and with the Community Advisory Board to design prototype interventions to overcome medication safety problems for older adults during transitions of care.

Principal Investigator(s)

Ranjit Singh, MB BChir, MBA, Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences
Huei-Yen (Winnie) Chen, PhD, Department of Industrial Engineering, School of Engineering and Applied Sciences
David Jacobs, PharmD, PhD, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences

UB Researcher(s)

Robert Wahler PharmD, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences
Jennifer Stoll, PhD, Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences
Andrew Baumgartner, MD, Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences
Sharon Hewner, RN, PhD, School of Nursing
Ann Bisantz, PhD, Department of Industrial Engineering, School of Engineering and Applied Sciences
Connor Wurst, PhD Candidate, Department of Industrial Engineering, School of Engineering and Applied Sciences
Kenneth Joseph, PhD, Department of Computer Science, School of Engineering and Applied Sciences

Funding Source(s) and Dates

Agency for Healthcare Research and Quality (AHRQ) - [9/1/2023 - 6/30/2027]

Abstract

Medication harm is a significant issue in global healthcare, particularly for older adults during transitions of care (TOC). This proposed Learning Lab aims to address this by empowering patients and caregivers, in partnership with healthcare teams, to ensure safe medication use during and after TOC. The project will begin with an analysis of the existing medication safety work system, leading to the design, development, and testing of scalable, human-centered interventions. These interventions will be tested in a simulated environment before being piloted in a clinical setting.

The research team will follow a systems-engineering methodology to achieve two main aims. Aim 1 involves a multifaceted problem analysis to understand the causes and consequences of medication problems in TOC. This includes studying patients’ and caregivers’ experiences, performing cognitive engineering analysis, and using health information exchange data to identify risk factors for unplanned hospitalizations and medication harm.

Aim 2 involves the design, development, implementation, and evaluation of patient-driven interventions. These interventions will be designed with input from key stakeholders and evaluated in both simulated and clinical environments.

The ultimate goal is to develop a cross-system learning laboratory that brings together older adults, caregivers, researchers, and healthcare teams to protect them from medication harm. This approach focuses on patients and caregivers and engages them in every step of the process. The infrastructure and pilot data from this proposal will lay the groundwork for future studies to improve medication safety for older adults.

Project Status

Active

Dissemination

Conference Presentations

  • Wurst C et al. Control Task Analysis of the Deprescription Process: A Pilot Study (paper presentation). 2023 Human Factors and Ergonomics Society International Annual Meeting, Washington, DC, Oct 2023.
  • Wurst C et al. The Cognitive Work of Deprescribing: A Human Factors Pilot (poster presentation). United States Deprescribing Research Network (USDeN) 3rd Annual Meeting, Boston, MA, May 2024.
  • Stoll J, Singh R, Wahler A, Wahler RG, Chen HY. Medication safety for older adults during transitions of care: patient and caregiver perspectives (poster presentation). North American Primary Care Research Group, 52nd Annual Meeting, Québec, Canada, Nov 2024.

Other (webinars, podcasts, news reports, Medscape, etc.)

  • Podcast: Medication Overload with David Jacobs (L. Kaiser & University at Buffalo, Interviewers; season 2, episode 13). (2024, April 30). Retrieved April 30, 2024, from the Driven to Discover podcast series.
  • Stakeholder Engagement Presentation: Wahler R, Stoll J, Singh R. Patient-Driven Medication Safety Learning Laboratory in Care Transitions AHRQ R18 (presentation). United States Deprescribing Research Network (USDeN), Quarterly Stakeholder Engagement Council Meeting, Mar 2024. 

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