UCL SCHOOL OF PHARMACY
BRUNSWICK SQUARE
Title of Project
Hospital electronic prescribing as a transformational tool to support quality improvement
Project Description
The UK government is encouraging adoption of electronic prescribing and medication
administration (EPMA) in hospitals as it is believed this will reduce patient harm due to
medication errors, and increase efficiency. While there is growing literature on the effects of
such systems on patient safety, the evidence base is by no means conclusive, with both UK
and international research suggesting that changing from paper-based to electronic medication
systems in the hospital setting prevents some kinds of errors but can introduce new ones. Less
is known about the effects on efficiency, with some international evidence that efficiency
gains in some areas are balanced by efficiency losses in other areas or by other professional
groups. There is very limited UK literature in this field. It has also been suggested that the
potential benefits of EPMA may not be realized if it is regarded as a ‘plug and play’ solution
superimposed on top of existing processes developed over many years of working with paperbased systems.
An alternative paradigm is to consider EPMA as a transformational tool to facilitate changes
in work flow and communication around the use of medication in the inpatient setting.
The aims of this PhD will be to explore how introducing EPMA in the UK hospital context
affects changes in work flow and communication around the use of medication, the extent to
which staff try to make it fit existing work processes versus creating new processes, and how
these changes can be used to facilitate improvements in the safety and quality of medication
use. Where relevant, consideration will also be given to exploring the impact on increased
efficiency and decreased patient harm for integrated versus non-integrated systems.
Anticipated outcomes will include a description of the changes to workflow and practice that
result from EPMA, a model of how these changes are perceived to occur (driven by EPMA
with hospital staff as more passive actors, versus actively driven by staff taking the
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UCL SCHOOL OF PHARMACY
BRUNSWICK SQUARE
opportunity to review systems and processes), and a description of the characteristics of
structures, processes and the environment which help organisations achieve quality,
efficiency and safety with EPMA.
This studentship is based on a collaborative partnership between UCL and Cerner, an
international leader in the development and implementation of healthcare technologies.
Academic supervisors are based at UCL School of Pharmacy and the UCL Interaction Centre,
a centre of excellence in human-computer interaction research.
Main Methods and Techniques to be employed
The PhD will involve case studies of hospitals in the process of implementing, and having
already implemented EPMA, including standalone EPMA solutions as well as EPMA
integrated into other components of the electronic medical record and medication
management systems within and across care settings.
Data collection methods are likely to include interviews, observations, document analysis,
process mapping and workflow analysis, drawing on methods used in business process
redesign and ergonomics. Analysis will be based around socio-technical models and/or actornetwork theory, as well as considering EPMA as a boundary object - a sociological concept to
describe how something is used in different ways by different groups for different purposes.
Person specifications
The successful applicant will be expected to have a UK Bachelor’s degree in Pharmacy,
Healthcare, Psychology or Human-Computer Interaction, awarded with first or upper secondclass Honours, or an overseas qualification of an equivalent standard from a recognised
higher education institute, or a recognised taught Master’s degree. Experience in a healthcare
setting would be preferred.
Please note that this studentship is limited to students with Home/ EU tuition fee status
and that we would like the successful candidate to commence the programme on the 1st
September 2016. The studentship will be funded for 36 months and the stipend rate will be at
least £16,057 pro rata.
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UCL SCHOOL OF PHARMACY
BRUNSWICK SQUARE
How to apply
Applications must only include CV, personal statement plus the contact details of two
referees and should be sent to Mr Victor Diran (v.diran@ucl.ac.uk).
For any academic queries please contact Prof Bryony Dean Franklin
(https://iris.ucl.ac.uk/iris/browse/profile?upi=BFRAN90).
Closing date of application is Monday 23rd May 2016 (5pm UK time).
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