Evaluation of the Application of Lean and Just-in-Time Information for Dynamic Decision-making to Reduce the Occurrence of Nurse Medication Administration Errors: A Clinical Trial and Agent Based Modeling Approach

The primary objective of this study is to measure the effects of providing just-in-time (JIT) information to nurses during the medication administration process. While the expectation is that having access to JIT information is beneficial for healthcare providers, other factors such as the information being distracting, misinterpreted, difficult to use, or even have a detrimental effect, could be of no value, or lead to adverse consequences.A clinical study was performed to evaluate the effect of JIT information on error occurrence during the administration of medication. A smartphone app was designed to convey information to the nurses on an "on-demand" basis. The clinical study used a control group which had access to conventional information resources including a laptop based electronic medical records system and Medication Administration Record, and an experimental group which had access to the smartphone app. The University of Tennessee Health Innovation Technology Laboratory was used as the test environment. The results indicated that the availability of JIT information made a significant difference in reducing the occurrence of the error, as well as improving the understanding of patient chart information and decreasing the time for administering medication.An agent-based computer simulation model (ABM) was developed using the information generated from the clinical trial to validate that a model of the medication administration process could be developed. This model was used to estimate the likelihood of the occurrence of the error at various levels of information input.