Royal Cornwall s implementation plan: A Chief Pharmacist s perspective
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1 Royal Cornwall s implementation plan: A Chief Pharmacist s perspective Iain Davidson, Chief Clinical Information Officer and Chief Pharmacist, Royal Cornwall Hospitals NHS Trust 13 April 2016
2 GS1 at The Royal Cornwall Hospital A Chief Pharmacist s Perspective Iain Davidson Chief Pharmacist & CCIO - RCHT April 2016
3
4 Some Facts and Figures The NHS spends around 6.7bn per year on medicines in hospitals (Lord Carter review) Between 2003 and 2013, the number of prescription items per year for any one person in England increased from 13 to 19 (NICE) 5% to 8% of unplanned hospital admissions are due to medication issues (NICE) 300m of medicines wasted every year (Kings Fund) 200m stockholding of acute hospital pharmacy departments (Lord Carter review) 1 invested in clinical pharmacy delivers 5 return (Lord Carter review) 55% of pharmacy team s time is spent on infrastructure services - aim is 80% on clinical services (Lord Carter review)
5 GS1 Adoption Objectives Improved patient safety Releasing time to Care Improved Efficiency
6
7 Pharma Where Does GS1 Add Value? Wholesaler Hospital Pharmacy Stores Robot DRUG ORDER Patient Admitted Medicines Prescribed on EPMA Stock Issue Dispensing & Labelling Patient Discharged Administration to Patient using EPMA Delivery to Ward Ward Electronic Cabinets
8 Pharma Where Does GS1 Add Value? Wholesaler Hospital Pharmacy Stores Robot DRUG ORDER Patient Admitted Medicines Prescribed on EPMA Stock Issue Dispensing & Labelling Patient Discharged Administration to Patient using EPMA Delivery to Ward Ward Electronic Cabinets
9 Pharma Patient Admitted Patient Discharged Where Does GS1 Add Value? GTIN & GLN GTIN & GLN GTIN & GSRN Wholesaler GTIN & GSRN Medicines Prescribed on EPMA GTIN & GLN Administration to Patient using EPMA Hospital Pharmacy Stores GTIN & GSRN GTIN & GSRN GTIN Stock Issue Robot DRUG ORDER GTIN & GSRN GLN & GSRN Delivery to Ward Ward Electronic Cabinets Dispensing & Labelling GLN, GTIN & GSRN
10 Pharma Patient Admitted Patient Discharged Where Does GS1 Add Value? GTIN & GLN GTIN & GLN GTIN & GSRN Wholesaler GTIN & GSRN Medicines Prescribed on EPMA GTIN & GLN Administration to Patient using EPMA Hospital Pharmacy Stores GTIN & GSRN GTIN & GSRN GTIN Stock Issue Robot DRUG ORDER GTIN & GSRN GLN & GSRN Delivery to Ward Ward Electronic Cabinets Dispensing & Labelling GLN, GTIN & GSRN
11 We ve Got All the Gear!
12 We just need to link it up better.. GS1 GS1 GS1 GS1 GS1
13 Why is this important? Ref Bob Wachter presentation
14 Examples
15 Royal Cornwall Hospitals Trust Scan4Safety
16 RCHT - Electronic Drug Ordering Scan4Safety
17 RCHT - Electronic Drug Ordering Scan4Safety GLN GSRN GTIN
18 RCHT - Electronic Drug Ordering Scan4Safety - safer and more efficient Percentage of Workload Dispensed before 10.30am Pre-implementation (Oct 13) 23% Post-implementation (March 14) 35%
19 RCHT - Electronic Drug Ordering Scan4Safety Missed Doses Critical Meds Medication Unavailable 1,20% 1,00% 0,80% 0,60% 0,40% Medication Unavailable Lineair (Medication Unavailable) 0,20% 0,00% Jan/14 Feb/14 Mrt/14 Apr/14 Mei/14 Jun/14 Jul/14 Aug/14 Sep/14 Okt/14 Nov/14 Dec/14 Jan/15 Feb/15 Mrt/15 Apr/15 Mei/15 Jun/15 Jul/15 Aug/15 Sep/15 Okt/15
20 Sunderland Royal Hospital Rod Beard - Director of Pharmacy Linking eprescribingto Robotic Dispensing
21 Linking eprescribing to Robotics
22 Sunderland Experience Four staff were released for re-deployment 500,000 in stockholding efficiency above that suggested by the business case was identified Products dispensed by the electronic prescribing - robot system produced zero dispensing errors The speed of dispensing increased also, as the electronic prescribing - robot combination permitted almost instantaneous dispensing from the point of a doctor entering a prescription
23 Isle of Wight - St Marys Hospital Gill Honeywell - Chief Pharmacist Linking eprescribing, Ward Stock and Dispensing
24 EPMA-EDC-Robot link 11% reduction in ward drug spend 83% reduction in missed doses Reduced length of stay Frees up nursing time to care Robust financial audit trail Return on Investment - 3 years
25 Improved patient safety GS1 - Can it Deliver? Releasing time to Care Improved Efficiency
26 Improved patient safety GS1 - Can it Deliver? Releasing time to Care Improved Efficiency
27 What Do We Need?
28 Work with Our Suppliers NHS Benchmarking Data 2015
29 How Does it Fit All Together? Unique Identifier DM&D GTIN FMD Product Level Product level Product, Supplier & Batch Level Product,Supplier, Batch and Box Level
30 May 2014 Publication of DH eprocurement strategy Timeline for Initiatives June 2015 Lord Carter's review of efficiency in hospitals 2016 Implementation of GS1 and PEPPOL June 2016 Introduction of the concept of A Model Hospital June 2017 Implementation of NHS dm+d July 2011 Publication of FMD Feb 2016 Publication of FMD Delegated Acts 36 Mon (2016+3) Complete FMD Implementation
31 May 2014 Publication of DH eprocurement strategy Timeline for Initiatives June 2015 Lord Carter's review of efficiency in hospitals 2016 Implementation of GS1 and PEPPOL June 2016 Introduction of the concept of A Model Hospital June 2017 Implementation of NHS dm+d July 2011 Publication of FMD Feb 2016 Publication of FMD Delegated Acts 36 Mon (2016+3) Complete FMD Implementation
32 Co-Ordinated & Collaborative
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