title: Who makes prescribing decisions in hospital inpatients? An observational study.
abstract: OBJECTIVE
  Errors involving drug prescriptions are a key target for patient safety initiatives. Recent studies have focused on error rates across different grades of doctors in order to target interventions. However, many prescriptions are not instigated by the doctor who writes them. It is important to clarify how often this occurs in order to interpret these studies and create interventions. This study aimed to provisionally quantify and describe prescriptions where the identity of the decision maker and prescription writer differed.
  
  
  METHODS
  Observational data was collected in six wards, 2 weeks per ward, at a single large UK teaching hospital over a 12-week period from January to April 2011.
  
  
  RESULTS
  In 112/183 (61%) cases where a new medicine was prescribed, the decision maker was not the prescription writer.
  
  
  CONCLUSIONS
  Decision making and the writing of prescriptions are generally not undertaken by the same doctor. Moreover, communication about prescriptions is poor. Further research in a larger sample of hospitals is required to confirm generalisability of the results, and to inform educational interventions to reduce error rates.
authors.affiliation: Division of Medical and Dental Education, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. s.ross@abdn.ac.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Ross
authors.forename: Laura
authors.initials: L
authors.lastname: Hamilton
authors.forename: Cristin
authors.initials: C
authors.lastname: Ryan
authors.forename: Christine
authors.initials: C
authors.lastname: Bond
mesh_terms: D003142:Communication; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006760:Hospitalization; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007297:Inpatients; D008505:Medical Staff, Hospital / Q000523:psychology / Q000706:statistics & numerical data; D008508:Medication Errors / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D006113:United Kingdom