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Reducing prescribing error: competence, control, and culture

¹ The School of Pharmacy, 29–39 Brunswick Square, London WC1N 1AX, UK
² Wolfson Unit of Clinical Pharmacology, University of Newcastle, Newcastle upon Tyne NE2 4HH, UK; National Institute for Clinical Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA, UK
³ Academic Pharmacy Unit, Hammersmith Hospitals NHS Trust and The School of Pharmacy, Hammersmith Hospital, London W12 0HS, UK

Correspondence to:
Professor N Barber
The School of Pharmacy, 29–39 Brunswick Square, London WC1N 1AX, UK; nick{at}nickbarber.org Medication errors are probably the most prevalent form of medical error, and prescribing errors are the most important source of medication errors. In this article we suggest interventions are needed at three levels to improve prescribing: (1) improve the training, and test the competence, of prescribers; (2) control the environment in which prescribers perform in order to standardise it, have greater controls on riskier drugs, and use technology to provide decision support; and (3) change organisational cultures, which do not support the belief that prescribing is a complex, technical, act, and that it is important to get it right. Solutions involve overt acknowledgement of this by senior clinicians and managers, and an open process of sharing and reviewing prescribing decisions.

Keywords: competence; computerised prescribing; culture; pharmacists; prescribing error

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