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Royal Perth Hospital has been 0 days without a Medication Error

Royal Perth Hospital has been 0 days without a Medication Error. 0. Integrated Medication Management to Prevent Errors. Barry Jenkins. Setting the scene. Squire funded program for reconciliation Short Stay Medical Unit (5E) Mandatory reporting of KPI reconciliation rate

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Royal Perth Hospital has been 0 days without a Medication Error

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  1. Royal Perth Hospital has been 0 days without a Medication Error 0

  2. Integrated Medication Management to Prevent Errors Barry Jenkins

  3. Setting the scene • Squire funded program for reconciliation • Short Stay Medical Unit (5E) • Mandatory reporting of KPI reconciliation rate • Goal: To establish a sustainable model for medication reconciliation. • Medication reconciliation is a an important marker for integrated medication management

  4. RPH Data

  5. Recipe for IMM • Performance Targets (APAC/PR/SQUIRE) • Functions & processes (Who does what) • Integrators (Brings people together) • Resources (mostly staff) • Monitor and evaluate (KPIs, surveys)

  6. < 3%? 32.1% 16.7% < 3%? Performance Targets

  7. Functions/processes

  8. Functions/processes

  9. Functions & processes (Who does what) • Who is the most effective? • Who needs the least training? • Which professional most suits the task? • Legislation? • Hospital characteristics? • Preferences and work-arounds

  10. Successful integrators • Software • TEDS (Dr and Pharm) • Ward round attendance (Dr/Pharm/Nurse) • Patient white board (Nurse/Pharm)

  11. OLD TEDS

  12. NEW TEDS Integrator - software

  13. TEDS outputs Discharge Summary Patient Medication List Prescription

  14. Resources:How many staff are needed? • SHPA stds - bed:pharmacist ratio based on ward type. Eg. medical ward is category 4 = 30 beds/FTE • Only a guideline, no std or allowance for; • ED (RPH:10-15 med. history interviews & confirmations/day) • Pre-admission clinics? • Short stay medical wards? • PBS Reform. • Admission/discharge rate. • Mixed staffing models

  15. Mixed pharmacy model Duty Clinical Pharm. Junior Pharm. Pharmacy Tech. * = Main duty Validation/docum. of pat. med. hx  * Assist in obtaining pat. Med. hx info. * Reconciliation of medications on adm. *  Entry of patient medications into TEDS *   Co-ordination of medication supply * Ward round (collaborative action plan) * Clinical review *  Reconciliation of medications on DC *  Generate DC prescription from TEDS  * Organise PBS and/or RPH outpat. Rx  * Liaison with community care providers *  Assist in discharge process * Provide pat. med. list & advice on DC * 

  16. Monitoring and evaluation • Main aim is to track progress whilst making changes. • KPIs to measure effectiveness of changes/system • Medication reconciliation is the best stand-alone KPI • Survey for staff acceptance of process changes • Commitment to increase resources to reach target

  17. 0.5CP 1 CP 1CP 1CP 1CP 0.4 JP 0.5 JP 0.5 JP 0.5 Tech The 4 stages of reconciliation KPI

  18. Satisfaction Survey questions

  19. Nursing

  20. Medical

  21. Conclusion • “Invaluable” Registrar • “Excellent service; improves patient outcomes” Registrar • “Huge improvements. Best thing since sliced bread!!!” RN Acknowledgments Mern Low Quan Tran Lea Dias Robyn Hutchings Katherine Birkett Samantha Hilmi Chris Beer Jacquie Garton-Smith Stephen Witney

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