Connecting eP to eCupboards l L essons L earnt Gillian Honeywell Chief Pharmacist July 2015 NHS Technology Fund Safer Wards Safer Hospitals Population 140000 2m visitors pa ID: 253744
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FIXING THE MISSING LINKConnecting eP to eCupboards – lLessons Learnt
Gillian HoneywellChief PharmacistJuly 2015
NHS Technology Fund:
Safer Wards Safer HospitalsSlide2
Population: 140,000, 2m visitors pa One unique organisation:
Acute hospitalCommunityAmbulance
Mental
Health
‘
One front door’ GP and EDVanguard site
The Isle of WightSlide3
Minimise duplication of data entryPaperless from prescribing to administrationRationalise and amalgamate ward stockImprove access to medicinesAudit trail from prescribing to patient Reduced delaysImprove efficiencyKnowledge at the press of a button
Right Drug, Right Patient, Right Time
Safety,
effectiveness,
patient experienceSlide4
Legibility – Semtex!Not the Only Why:Slide5
7 day working
Access to Vision 360
Electronic prescribingSlide6Slide7Slide8
Missed doses Trust Quality ReportSlide9
RRISK CHANGESlide10
RISK CHANGESlide11
DOES SAFETY & QUALITY = SAVINGS?ADE cost £713 - £1,484 – CALL IT £1k: Medicines Reconciliation:
increase by 10%:Increased saving ~£10k pa
Missed Doses:
Assume 10% are avoidable. Pre EPMA??? 10% reduction: 250,000pa 25,000 avoidable, reduce by 10% = 2500 avoided, assume 10% cause ADE = 250
=
£250k paCategory 4 warnings: 170 pa heeded, assume 10% cause ADE =
£17k paSlide12
Does safety = savings?Conservative identified quality / safety
benefits >£270k pa
What is the cost of antibiotic resistance?
What is the cost of VTE?
What is the cost of readmissions when the GP gets poor information?Slide13
order
Duplication of data entry
Ward stock
JAC
Select drug
Prescription
Dose
Prescription
Dispense Slide14
Medicines vs prescriptionSupply to ward vs used by wardMedicine matches prescriptionStock availabilityClosed loopWhat’s Missing?Slide15
Pharmacy system 1980’sRobot 2006Vertical carousel 2007Keyless patients own drugs lockers 2011EPMA
2012Automated storage on wards 2014
NHSE Technology Fund
Technology
PathwaySlide16
Storyboard: 15 areas covered by 12 cupboards One shared clinic room for neighbouring wards Rationalise stock
Interface Omnicell with JAC stock and EPMA
Select medicine by patientSlide17
Interface Map
supplier
PAS / PORTAL
patientSlide18
InterfacingInterface EPMA with Omnicell, prescription appears on cupboardSlide19
InterfacingDetails of currentmedicinesSlide20
Interfacing
Order arrives in JAC, goes to
Robot and Vertical CarouselsSlide21
Experience:Clare Barton, Staff Nurse on Colwell Ward, said: “The biggest difference it has made is that we don’t have
to hunt around for keys anymore because it’s all finger coded. It makes you more aware of the drugs you’re handling—rather than routing through cupboards, a specific cupboard opens
for a specific drug. The machine will only offer you what you’re
asking,
which is a way of it being checked. This system is
time-saving and I think it is great! “ Slide22
Experience:Jackie Harry on NICU Ward, said:
“After very few hiccups I really like it, we have much better stock control and expiry date management, it’s really easy to use even in an emergency. We have saved time hunting for keys and searching in cupboards – we know we have the stock and the cupboard takes us to it. Invaluable. Really time efficient and safe“ Slide23
BEFORE
AFTER
SafetySlide24
BEFORE
AFTERSlide25
EfficiencyCaution note: based on 6-12 month data
> 10 hours a week Pharmacy time
> 35 hours a week nursing time
6
% reduction in stockholding value (
£6k
)
11% reduction in supplies to wards (
£140k pa
)Slide26
Efficiency
Vision to all
Omnicells
for restricted meds
Stock usage vs stock supply
No manual transfer of information
Information entered once
– prescribing
Staff time released to careSlide27
LESSONS LEARNT:Clear vision and strategy
Maximise benefits from each step
Gain
understanding &
ownership from users
Demonstrate and celebrate success Long term monitoring of benefitsSlide28
INNOVATION WITH TECHNOLOGYInstalling:Slide29
gillian.honeywell@iow.nhs.uk
www.iow.nhs.uk