Transcript Document
ePMA - Benefits Realisation at Harrogate Paul Golightly Acting ePMA Lead Pharmacist Harrogate District NHS Foundation Trust Objectives • Describe implementation of ePMA solution at HDFT • Describe the approach to determine benefits at HDFT – Projected benefits – Baseline data • Key Messages Implementation • ePMA solution (MedChart) implemented at HDFT during 2012 • Initial ward went live April 2012 • Rapid roll-out – Go-live on a new ward approx. every two weeks – Most wards/departments live by Nov 2012 – Only ED and Outpatients not live • Baseline data collected prior to initial go-live • Simple approach to measuring benefits Planned Benefits • Avoidance of harm (inc. Cost) – Clarity of prescribing etc. • • • • Reduction in missed doses Increased Staff Productivity Allergy documentation Prescribing Quality Benefits – Antibiotic Stewardship – Decision Support etc. Baseline Data • Incident reports – Prescribing incidents – Administration incidents – Particularly allergy incidents • Productivity – Time taken for charts to go to pharmacy – Time taken for charts to be re-written – Time for ‘lost’ charts • Baseline Audits – Missed doses – Allergy documentation – Antibiotic Prescribing Incident Reports • How many incidents reported on DATIX? – Classified by actual/potential harm • Look for a reduction in incidents. Aimed for: – – – – Zero incidents of Fatal potential harm Zero incidents of Major actual harm 50% reduction in potentially harmful admin errors 20% reduction in potentially harmful prescribing errors • Specifically monitor Allergy Incidents – Aim for zero allergy incidents (of known allergies) Staff Productivity • Problems with paper drugs charts – ‘Lost’ on the ward – In pharmacy – Only last 2 weeks • Time and motion studies carried out to assess the time taken up with activities related to the above – 912 hours/year doctor time rewriting drug charts – 2190 hours/year nursing time looking for ‘lost’ drug charts – 1460 hours/year nursing time taking charts to/from pharmacy • £45,000 per year • Further benefits to pharmacy around productivity – Activity on wards – Charts, discharge prescriptions etc. Audits • Missed doses – 80% reduction in missed doses – 16,600 pre-ePMA, 3,300 post-ePMA • Allergy Documentation – Paper charts audit – 95% completed – ePMA – 100% completed • Antibiotic Stewardship – Trust standards are for Indication & Duration to be documented on the prescription for all antibiotics • Paper charts – 35% (Indication) & 40% (Duration) • ePMA – 95% (Indication) & 80% (Duration) Future Developments • Significant benefits in reporting from the system – Audits – Investigations – Performance monitoring – Targeting activity • Currently working with information services to develop reports from the system Summary/Key Messages • Benefits of ePMA solutions are readily apparent – Safety, clarity of prescribing, full unambiguous medication record • Simple approach to measuring benefits – Choose easily measurable benefits – Simple approach to measure benefits – Simple approach helps ‘buy-in’ from consultants etc. • Easily understand the benefits • Focus on the positive – Remember - it will NOT be worse than pen & paper! ANY QUESTIONS?