Table 2 Effective behaviour change techniques to reduce prescribing errors in HIT
BCT cluster | BCT label | Key behaviour | ER (% effect. ratio) |
|---|---|---|---|
1. Goals and planning | 1.3 Goal setting (outcome) | ✓ Ensure prescriber or clinical involvement in HIT configuration and design; in clinical parameter setting for dosing support and other clinical decision support; in drug library design | 1 (100) |
1.7 Review outcome goal(s) | ✓ Review and modify HIT in response to prescriber feedback | 1 (100) | |
2. Feedback and monitoring | 2.1 Monitoring of behaviour by others without feedback | ✓ Observe and record prescriber workflow and behaviour with their knowledge but without providing feedback, in order to adapt system and in turn modify prescriber behaviour (e.g. drop-down menus that are contributing to selection errors may be modified after prescriber observation) | 1 (100) |
2.5 Monitoring of outcome(s) of behaviour without feedback | ✓ Monitor electronic prescriptions or orders generated by prescribers without providing feedback in order to prevent or detect errors (not for the purpose of study data collection) | 1 (100) | |
3. Social support | 3.2 Social support (practical) | ✓ Ensure clinical colleagues (e.g. ‘super-users’) or IT phone support available to give practical system support to prescribers and to answer questions | 1 (100) |
9. Comparison of outcomes | 9.1 Credible source | ✓ Deliver prescriber training, or information on the consequences of medication errors by a credible source such as an informatics pharmacist or other clinical healthcare professional | 1 (100) |
4. Shaping knowledge | 4.1 Instruction on how to perform a behaviour | ✓ Provide training sessions on how to use the system and prescribe a drug correctly; may be classroom or workbook-based | 0.91 (91) |
5. Natural consequences | 5.1 Information on health consequences | ✓ Alert the prescriber about the consequences of placing a specific medication order (e.g. patient allergy, drug-drug interaction, therapeutic duplication, contraindication) through system alerts or warnings; verbal or written information on medication errors may also be provided | 0.86 (86) |
7. Associations | 7.1 Prompts/cues | ✓ Provide visual on-screen alerts or pop-ups to prompt prescribers to change or adjust potentially erroneous or unsafe medication orders | 0.86 (86) |
8. Repetition and substitution | 8.1 Behavioural practice/rehearsal | ✓ Provide classroom or individual training sessions for prescribers to work through order examples, workbooks, online modules, or system demos | 0.80 (80) |