My role as a Medication Safety Officer (MSO) Joanna Taylor, Lead Pharmacist Medication Safety, Risk and Compliance
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1 My role as a Medication Safety Officer (MSO) Joanna Taylor, Lead Pharmacist Medication Safety, Risk and Compliance
2 Overview CNWL Trust in context Implementing NHS England PSA - improving medication incident reporting & learning MSO Challenges What s worked well Future MSO work
3 Trust Information CNWL provides integrated health & social care services for approx 3 million popn. in South East of England Services mostly provided in community (people s homes, community clinics, schools) + specialist in-patient units + offender care Patients treated adults/ older adults/ children: 269,042 patients treated in community (135,282 physical health patients; >70,000 sexual health patients) treated in hospital (900 physical health inpatients) Staff: (2000 nurses; 500 medical & dental; 500+ AHPs; 200+ social care) Structure: 3 Divisions (previously Service Lines) MHAS/ CHS/ SHS/ AOCD Mini organisations...own Directors & Board
4
5 Executive Director of Nursing & Quality Medication Safety, Risk & Compliance Pharmacist Safe Medication Practice Group
6 Yes Trying to... Not got capacity Not received any requests yet Yes Yes
7 Trying to...
8 MSO Challenges FOUR separate incident reporting systems in the Trust (x3 Datix; x1 Safeguard) Total no. meds incidents 2014/15 = approx.1,900 reported 13.4% of total PSIs reported to NRLS ( Mental Health Trust av. = 9.2%) Different medication categories Trustwide reports Themes/ trends? Who reports incidents? CD section reportable to CDAO? Different stance on reporting of non-cnwl medication PSIs (Acute trust/ GP/ Community Pharmacy/ Care Agency) CQUIN improve medication PSI reporting by 20%?2013/14 baseline Reliant on local Incident Team
9 MSO Challenges cont. Safe Medication Practice Group Getting trustwide representation Multi-professional (nurses/ medical rep) Aligned to Divisional structure Remit of the Group strategic or operational? New Chair Revised TOR Workload (Incidents/ PSAs/ Never Events/ Nursing medicine competency framework/ Meds. Safety audits/ CQC) Frequency of meetings
10 What s worked well! New Datix launched trustwide 1 st April (finally!) New standardised codes mapped to NRLS & non-patient safety codes ( Medication- Other ) Local lead pharmacists receive notifications CDAO receives all CD incidents Ability to update system with investigation details/ provide feedback/ correct mis-selected category codes Datix User Guide reporting & reviewing pharmacy/ medication error incidents Better quarterly reports...(tbc)
11 CNWL Datix Guide reporting medication incidents
12 What s worked well cont.! Learning Lessons local teams & trustwide e.g. (SUI) Lithium toxicity: monitoring responsibilities Clinical Risk Alert New SOP written/ communication to CCGs Quarterly Medication Incident local learning report template Regular SMPG Bulletin published
13 Learning Lessons
14 Safe Medication Practice Bulletin
15 Insulin Incidents Community Missed/ Delayed administration No or late notification of discharge Miss-communication within DN Team about caseload Duplicate administration Not checked that dose already administered Transcribing errors under/ over dosed Mental Health Unfamiliarity of insulin products/ devices
16 Future MSO work... Improve quality of incident reporting Deep dives for themes/ trends e.g. Insulin Monitoring trust response to recent PSAs Implementation of NICE Guidance: Medicines optimisation the safe and effective use of medicines to enable the best possible outcomes (NG5), March Recommendation 1.1 Systems for identifying, reporting and learning from medicines related patient safety incidents
17 Medicines Safety in Your Organisation Immediate / Longer term safety concerns Do you have systems in place? (up/ down/ horizontal learning) Is it an MDT approach? Is there a focus on learning? Who is responsible? It s everybody s business Your role.
18 Any questions?
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