Safety recommendation
It is recommended that the Department of Health and Social Care should consider how to prioritise the commissioning of research on human factors and clinical decision support systems; particularly in relation to the configuration of software system alerting and alert fatigue, to establish how best to maximise clinician response to high risk medication alerts.
Response:
Since publication of the HSIB report in October 2019, the Department of Health & Social Care has been working with national partners (such as NHSX, NHS England & Improvement, and the National Institute for Health Research) to discuss the report recommendation. This includes, how research might focus also on the design fundamentals of clinical decision support within ePMAs (e.g. designing out specific errors, thereby making software ‘alerts’ to the clinician unnecessary).
This work produced a detailed definition of the policy, service and research requirements, key policy and research questions, and potential methodological approaches. This initial scoping work was completed in January 2020, and the recommendation will now proceed through the Department’s internal research prioritisation processes.
This Departmental prioritisation process is currently underway, and it will be completed in March 2020. At that point, possible next steps for delivering research that address the HSIB recommendation will be agreed, and the Department can start work with our national partners to undertake relevant research commissioning activity. The Department will provide a further update, including timescales, when these details are known.
Response received on 17 January 2020.