20 We focus here on the role of the design and content of inpatient prescription charts http://www.selleckchem.com/products/mek162.html as a moderator of prescribing behaviour. This paper describes the Imperial Drug Chart Evaluation and Adoption Study (IDEAS), which considered how the choice architecture (the design and content) of prescription charts could influence prescribing behaviour building on the recommendations from the AoMRC report.11

While there is existing evidence that differences in prescription chart design can lead to significant variations in prescribing error rates,6 21 there is a lack of research into how a direct behavioural and user-centred approach to the design of paper prescription charts can influence prescribing behaviour. Aim and objectives Our aim was to evaluate whether a user-centred approach incorporating behavioural insights could enhance prescribing behaviour and reduce prescription errors in the inpatient setting. Our objectives were to take a user-centred approach to the redesign of a paper inpatient prescription chart, incorporating insights from behavioural economics, and to evaluate the impact of such changes on prescribing behaviour via an in situ simulation. Methods Setting The IDEAS study took place at Imperial College Healthcare NHS Trust (ICHNT), a large London

teaching hospital trust with three main hospital sites. This trust operates a typical UK model for the prescribing, supply and

administration of medication, in which prescribers handwrite medication orders onto a formatted inpatient prescription chart. The same prescription chart is also used by nursing staff to determine what medications are to be given to each patient, and to then record their administration. Charts are routinely reviewed by pharmacists to check that medication orders are legible, legal and clinically appropriate. The existing chart in clinical use is here referred to as the ICHNT chart. The multidisciplinary project team comprised four physicians, two behavioural scientists, four pharmacists and two graphic designers. The project took place between August 2011 and September 2013 and comprised three parts: (1) an exploratory phase to identify problems associated with current inpatient prescription charts; (2) iterative design of the IDEAS prescription chart; and (3) in situ simulation Cilengitide testing of the IDEAS chart in comparison with the ICHNT chart. The study was approved as a service evaluation within ICHNT; ethics approval was not required. Written consent was obtained from each participating healthcare professional. All data collected were anonymous and confidential. Phase 1: exploratory phase The initial exploratory phase employed several strategies. First, a review of hospital prescription charts from across the UK was performed.