Summary of participants.

Background Effective, integrated and coordinated communication is essential in providing high quality patient care. Little prior research has detailed the impact of electronic prescribing and medication administration (ePMA) systems on healthcare professionals’ (HCPs’) communication. We investigated hospital pharmacists’, doctors’ and nurses’ perceptions of how ePMA systems have affected, or are expected to affect, the way they communicate with each other in an inpatient setting. Methods A qualitative study in three English NHS hospitals: two used different inpatient ePMA systems, and one used paper-based prescribing. We conducted focus groups with pharmacists, and semi-structured individual interviews with doctors and nurses. Transcribed data were analysed inductively using thematic analysis. Results Nine focus groups, three at each hospital, were conducted with pharmacists with different levels of seniority (58 pharmacists in total). Fourteen doctors and twelve nurses took part in individual interviews. Four themes were generated: modes of communication, reduced pharmacist visibility, system limitations, and future aspirations for ePMA. Whether working with ePMA or paper-based systems, all participants preferred to communicate face-to-face to facilitate collaborative discussions regarding patient care. Participants perceived that ePMA reduced contact time with patients. Pharmacists perceived that both their physical ward presence and their written communication on medication charts had reduced since introduction of ePMA. Doctors felt they were now less likely to ask pharmacists questions due to pharmacists’ reduced physical presence on the ward. Hardware and software limitations were identified by all HCPs, with suggestions made for future developments to better support communication. Conclusion ePMA does not necessarily support communication among HCPs. Pharmacists and doctors were also concerned that ePMA reduces communication between themselves and their patients. Hospital managers should ensure sufficient hardware for HCPs, including pharmacists, to conduct their work in clinical areas, and work with ePMA system suppliers to develop ways of enhancing, rather than inhibiting, communication.研究背景 高效、整合且协同的沟通是提供高质量患者护理的核心前提。此前鲜有研究详细阐述电子处方与给药（electronic prescribing and medication administration, ePMA）系统对医护人员（healthcare professionals, HCPs）沟通的影响。本研究旨在探究医院药师、医师与护士对电子处方与给药系统如何影响（或预期将影响）其在住院病房场景下彼此沟通方式的认知。 研究方法 本研究在英国三家国民保健服务（National Health Service, NHS）医院开展定性研究：其中两家采用不同的住院电子处方与给药系统，另一家采用纸质处方流程。我们针对药师开展焦点小组访谈，针对医师与护士开展半结构化个人访谈。转录后的研究资料采用归纳式主题分析法进行分析。 研究结果 本研究共开展9场焦点小组访谈（每家医院3场），受访药师涵盖不同年资层级，总人数为58名。另有14名医师与12名护士参与了个人访谈。最终提炼出四大主题：沟通模式、药师病房存在感下降、系统局限性以及对电子处方与给药系统的未来展望。无论使用电子处方与给药系统还是纸质处方流程，所有受访者均更倾向于面对面沟通，以开展针对患者护理的协作讨论。受访者认为，电子处方与给药系统缩短了医护人员与患者的接触时间。药师群体反馈，自电子处方与给药系统推行以来，其在病房的实体存在感以及在用药医嘱单上的书面沟通均有所减少。医师群体则表示，由于药师在病房的实体存在感下降，他们如今向药师咨询问题的可能性有所降低。所有医护人员均指出了系统在硬件与软件层面的局限性，并针对未来系统优化提出了有助于改善沟通的改进建议。 研究结论 电子处方与给药系统未必能促进医护人员之间的沟通。药师与医师还担忧，电子处方与给药系统会削弱其与患者之间的沟通效果。医院管理者应确保为医护人员（包括药师）提供充足的硬件设备，以保障其在临床区域开展工作，并与电子处方与给药系统供应商合作，开发能够强化而非抑制沟通的系统优化方案。