Flávia Silva de Souza, Ana Carolina Sanches Zeferino, Rebecca Thaffenne Santos Oliveira Nunes, Célio Manso de Azevedo Junior, Níssia Carvalho Rosa Bergiante
{"title":"Enhancing healthcare resilience: systemic medication errors debate in emergency departments with Soft System Methodology.","authors":"Flávia Silva de Souza, Ana Carolina Sanches Zeferino, Rebecca Thaffenne Santos Oliveira Nunes, Célio Manso de Azevedo Junior, Níssia Carvalho Rosa Bergiante","doi":"10.1590/1413-81232025306.20912024","DOIUrl":null,"url":null,"abstract":"<p><p>The effective management of medications is a critical component of a resilient healthcare system, directly impacting patient health outcomes. However, its complexity can lead to errors, compromising patient safety and treatment efficacy. Through exploratory and qualitative action research, utilizing data from secondary sources and interviews with the medication management team, Soft Systems Methodology (SSM) was employed in three stages. Using CATWOE (Customers, Actors, Transformation, Worldview, Owner e Environmental) framework, seven transformations were defined, with systemic propositions developed for four of them, namely, improving prescription readability, adjusting the medication procurement process to demand, enhancing working conditions, and optimizing team experience. These propositions involved the analysis of their causes and mitigating measures. By emphasizing a collaborative approach and seeking integrated solutions, SSM proved to be instrumental in achieving system resilience.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 6","pages":"e20912024"},"PeriodicalIF":1.1000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ciencia & saude coletiva","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1590/1413-81232025306.20912024","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/21 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
The effective management of medications is a critical component of a resilient healthcare system, directly impacting patient health outcomes. However, its complexity can lead to errors, compromising patient safety and treatment efficacy. Through exploratory and qualitative action research, utilizing data from secondary sources and interviews with the medication management team, Soft Systems Methodology (SSM) was employed in three stages. Using CATWOE (Customers, Actors, Transformation, Worldview, Owner e Environmental) framework, seven transformations were defined, with systemic propositions developed for four of them, namely, improving prescription readability, adjusting the medication procurement process to demand, enhancing working conditions, and optimizing team experience. These propositions involved the analysis of their causes and mitigating measures. By emphasizing a collaborative approach and seeking integrated solutions, SSM proved to be instrumental in achieving system resilience.
期刊介绍:
Ciência & Saúde Coletiva publishes debates, analyses, and results of research on a Specific Theme considered current and relevant to the field of Collective Health. Its abbreviated title is Ciênc. saúde coletiva, which should be used in bibliographies, footnotes and bibliographical references and strips.