title: Best practice strategies to safeguard drug prescribing and drug administration: an anthology of expert views and opinions.
abstract: BACKGROUND
  While evidence on implementation of medication safety strategies is increasing, reasons for selecting and relinquishing distinct strategies and details on implementation are typically not shared in published literature.
  
  
  OBJECTIVE
  We aimed to collect and structure expert information resulting from implementing medication safety strategies to provide advice for decision-makers.
  
  
  METHODS
  Medication safety experts with clinical expertise from thirteen hospitals throughout twelve European and North American countries shared their experience in workshop meetings, on-site-visits and remote structured interviews.
  
  
  METHODS
  We performed an expert-based, in-depth assessment of implementation of best-practice strategies to improve drug prescribing and drug administration.
  
  
  METHODS
  Workflow, variability and recommended medication safety strategies in drug prescribing and drug administration processes.
  
  
  RESULTS
  According to the experts, institutions chose strategies that targeted process steps known to be particularly error-prone in the respective setting. Often, the selection was channeled by local constraints such as the e-health equipment and critically modulated by national context factors. In our study, the experts favored electronic prescribing with clinical decision support and medication reconciliation as most promising interventions. They agreed that self-assessment and introduction of medication safety boards were crucial to satisfy the setting-specific differences and foster successful implementation.
  
  
  CONCLUSIONS
  While general evidence for implementation of strategies to improve medication safety exists, successful selection and adaptation of a distinct strategy requires a thorough knowledge of the institute-specific constraints and an ongoing monitoring and adjustment of the implemented measures.
authors.affiliation: Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. hanna.seidling@med.uni-heidelberg.de.|Cooperation Unit Clinical Pharmacy, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. hanna.seidling@med.uni-heidelberg.de.
authors.forename: Hanna M
authors.initials: HM
authors.lastname: Seidling
authors.affiliation: Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.|Cooperation Unit Clinical Pharmacy, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Marion
authors.initials: M
authors.lastname: Stützle
authors.affiliation: Pharmacy Department, University Hospital of Heidelberg, Heidelberg, Germany.|Cooperation Unit Clinical Pharmacy, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Hoppe-Tichy
authors.affiliation: Department of Pharmacy, CNRS, TIMC-IMAG UMR 5525, Themas, Grenoble-Alpes University, Grenoble University Hospital, Grenoble, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Allenet
authors.affiliation: Department of Pharmacy, CNRS, TIMC-IMAG UMR 5525, Themas, Grenoble-Alpes University, Grenoble University Hospital, Grenoble, France.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Bedouch
authors.affiliation: Pharmacy, Geneva University Hospitals (HUG), Geneva, Switzerland.|School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bonnabry
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, Birmingham, England, UK.
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Coleman
authors.affiliation: Research Institute for Medicines (iMedULisboa), Department of Social Pharmacy, University of Lisboa, Lisbon, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernandez-Llimos
authors.affiliation: Division of Medical Information Sciences, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Lovis
authors.affiliation: Pharmacy Department, Hospital da Luz, Lisbon, Portugal.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Rei
authors.affiliation: Pharmacy Department, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Dominic
authors.initials: D
authors.lastname: Störzinger
authors.affiliation: Pharmacy Department, University Hospital of Heidelberg, Heidelberg, Germany.
authors.forename: Lenka A
authors.initials: LA
authors.lastname: Taylor
authors.affiliation: University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, Birmingham, England, UK.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Pontefract
authors.affiliation: Department of Hospital Pharmacy, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Patricia M L A
authors.initials: PM
authors.lastname: van den Bemt
authors.affiliation: Department of Hospital Pharmacy, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Heleen
authors.initials: H
authors.lastname: van der Sijs
authors.affiliation: Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.|Cooperation Unit Clinical Pharmacy, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Walter E
authors.initials: WE
authors.lastname: Haefeli
mesh_terms: D011307:Drug Prescriptions / Q000592:standards*; D055695:Electronic Prescribing / Q000592:standards*; D006801:Humans; D038622:Internationality; D008508:Medication Errors / Q000517:prevention & control*; D059065:Medication Reconciliation / Q000379:methods / Q000592:standards; D010595:Pharmacists / Q000592:standards*; D011446:Prospective Studies
keywords: CPOE; Computerized physician order entry; Expert discussion; Inpatient care; Medication reconciliation; Medication safety; Quality improvement