Abstract

The care home medication system is an area that has not been investigated extensively. There is currently little understanding about how the system works and the medication problems. Current medication errors studies in all sectors of healthcare have largely adopted a bottom-up approach in understanding and analysing medication errors. Incidences of medication errors have either been collected retrospectively for example through error reporting systems, medication reviews, case record reviews or prospectively for example through direct observations. Following this, the causes of medication errors were analysed to build a picture of the system. This approach is largely limited by the identification of medication errors and the causes of these errors. Thus there is a risk of unknown knowledge gaps of the system. A way to overcome this limitation is to first analyse the work system before investigating the problems. Work Domain Analysis (WDA), which is the first layer of analysis in the suite of methods in Cognitive Work Analysis (CWA) was used to model the care home medication system. This visual representation of the work system was subsequently used to analyse medication errors. A discussion of the application of WDA to analyse medication errors follows.

The aim of the seminar is to introduce Work Domain Analysis and its applicability to healthcare based on Rosemary’s phd research.