Effects of mental demands during dispensing on perceived medication safety and employee well-being: A study of workload in pediatric hospital pharmacies

Holden, Richard J.; Patel, Neal R.; Scanlon, Matthew C.; Shalaby, Theresa M.; Arnold, Judi M.; Karsh, Ben-Tzion

doi:10.1016/j.sapharm.2009.10.001

« Previous Next »Research in Social and Administrative Pharmacy
Volume 6, Issue 4 , Pages 293-306, December 2010

Effects of mental demands during dispensing on perceived medication safety and employee well-being: A study of workload in pediatric hospital pharmacies

Richard J. Holden, Ph.D.
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Division of Ergonomics, School of Technology and Health, Royal Institute of Technology (KTH), Stockholm, Sweden
- Corresponding author. Center for Quality and Productivity Improvement, University of Wisconsin-Madison, 1550 Engineering Drive, Madison, WI 53706, USA. Tel.: +1 608 263 3610; fax: +1 608 262 8454.
Neal R. Patel, M.D.
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
Matthew C. Scanlon, M.D.
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
Theresa M. Shalaby, B.S.N.
- Asklepion Pharmaceuticals, LLC, Brentwood, TN, USA
Judi M. Arnold, B.S.N.
- Pediatric Critical Care, Vanderbilt Children's Hospital, Nashville, TN, USA
Ben-Tzion Karsh, Ph.D.
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA

published online 12 February 2010.

Abstract

Background

Pharmacy workload is a modifiable work system factor believed to affect both medication safety outcomes and employee outcomes, such as job satisfaction.

Objectives

This study sought to measure the effect of workload on safety and employee outcomes in 2 pediatric hospitals and to do so using a novel approach to pharmacy workload measurement.

Methods

Rather than measuring prescription volume or other similar indicators, this study measured the type and intensity of mental demands experienced during the medication dispensing tasks. The effects of external (interruptions, divided attention, and rushing) and internal (concentration and effort) task demands on perceived medication error likelihood, adverse drug event likelihood, job dissatisfaction, and burnout were statistically estimated using multiple linear and logistic regression.

Results

Pharmacists and pharmacy technicians reported high levels of external and internal mental demands during dispensing. The study supported the hypothesis that external demands (interruptions, divided attention, and rushing) negatively impacted medication safety and employee well-being outcomes. However, as hypothesized, increasing levels of internal demands (concentration and effort) were not associated with greater perceived likelihood of error, adverse drug events, or burnout and even had a positive effect on job satisfaction.

Conclusions

Replicating a prior study in nursing, this study shows that new conceptualizations and measures of workload can generate important new findings about both detrimental and beneficial effects of workload on patient safety and employee well-being. This study discusses what those findings imply for policy, management, and design concerning automation, cognition, and staffing.

Keywords: Workload, Mental demands, Medication error, Safety, Employee well-being, Human factors