Imperial College London
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DrGevaGreenfield

Faculty of Medicine, School of Public Health

Research Fellow in Public Health
 
 
 
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Contact

 

+44 (0)20 7594 8595g.greenfield Website

 
 
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Location

 

314Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Bitan:2019:10.1177/0018720819837037,
author = {Bitan, Y and Parmet, Y and Greenfield, G and Teng, S and Cook, RI and Nunnally, ME},
doi = {10.1177/0018720819837037},
journal = {Human Factors},
pages = {1315--1325},
title = {Making sense of the cognitive task of medication reconciliation using a card sorting task},
url = {http://dx.doi.org/10.1177/0018720819837037},
volume = {61},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE:: To explore cognitive strategies clinicians apply while performing a medication reconciliation task, handling incomplete and conflicting information. BACKGROUND:: Medication reconciliation is a method clinicians apply to find and resolve inconsistencies in patients' medications and medical conditions lists. The cognitive strategies clinicians use during reconciliation are unclear. Controlled lab experiments can explore how clinicians make sense of uncertain, missing, or conflicting information and therefore support the development of a human performance model. We hypothesize that clinicians apply varied cognitive strategies to handle this task and that profession and experience affect these strategies. METHOD:: 130 clinicians participated in a tablet-based experiment conducted in a large American teaching hospital. They were asked to simulate medication reconciliation using a card sorting task (CaST) to organize medication and medical condition lists of a specific clinical case. Later on, they were presented with new information and were asked to add it to their arrangements. We quantitatively and qualitatively analyzed the ways clinicians arranged patient information. RESULTS:: Four distinct cognitive strategies were identified ("Conditions first": n = 76 clinicians, "Medications first": n = 7, "Crossover": n = 17, and "Alternating": n = 10). The strategy clinicians applied was affected by their experience ( p = .02) but not by their profession. At the appearance of new information, clinicians moved medication cards more frequently (75.2 movements vs. 49.6 movements, p < .001), suggesting that they match medications to medical conditions. CONCLUSION:: Clinicians apply various cognitive strategies while reconciling medications and medical conditions. APPLICATION:: Clinical information systems should support multiple cognitive strategies, allowing flexibility in organizing information.
AU  - Bitan,Y
AU  - Parmet,Y
AU  - Greenfield,G
AU  - Teng,S
AU  - Cook,RI
AU  - Nunnally,ME
DO  - 10.1177/0018720819837037
EP  - 1325
PY  - 2019///
SN  - 0018-7208
SP  - 1315
TI  - Making sense of the cognitive task of medication reconciliation using a card sorting task
T2  - Human Factors
UR  - http://dx.doi.org/10.1177/0018720819837037
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30912979
UR  - http://hdl.handle.net/10044/1/68791
VL  - 61
ER  -
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