Innovative Practice in a regional hospital - Clinical unit based pharmacist and a ward based pharmacy assistant Sunshine Coast Hospital and Health Service (SCHHS) Nambour Hospital Pharmacy Department Presenter: Liane Ward-Panckhurst, Zoe Brimblecombe & Robyn Fisher HRT 1520 Innovations Workshops and Awards 19-20 November 2015, Sydney
Key problem: Inability to provide patient-centred care and an optimal Clinical Unit Pharmacy Service Aim of Innovation: Maximise patient safety and prove the concept of Multi-disciplinary Team (MDT) Pharmacy Services Baseline data/ Current situation: No Clinical Unit Based Pharmacy Services and no Ward Based Pharmacy Assistant Changes implemented: Team Based Pharmacist Rounding with the Medical Team Pharmacy Assistant allocated to the Clinical Area as part of the MDT Outcomes: DMR increased by 19% MAP increased by 17% Discharge Summaries with DMR increased by 28% No. of D/C Summaries with No Medication Information decreased by 32% Liane Ward-Panckhurst Senior Project Pharmacist Liane.ward-panckhurst@health.qld.gov.au Sunshine Coast Hospital and Health Service 2
Key Problem Inability to: Provide Patient Centred Care Meet SCHHS Pharmacy Service KPIs Comply with SCHHS expectations for National Safety and Quality Healthcare Standards (eg Standard 4) Provide an optimal Clinical Unit Pharmacy Service Comply with admission/discharge timelines Resource clinical area efficiently 3
2015 Confidential Draft Discussion Document 4 Aim of this innovation A very excited and enthusiastic Project Team aimed to: Provide Patient Centred Care and to achieve best medication outcomes Increase Patient satisfaction and enhance consumer engagement Exceed NSQHS Standard 4 Medication Safety compliance Prove the concept of Multi-disciplinary Team (MDT) Pharmacy Services Develop an Innovative Practice Model for the Tertiary Hospital (Opening November 2016) Maximise patient safety Increase the scope of practice of Pharmacy Assistants and embed this practice into the MDT
5 Baseline Data / Current Situation Activity Ward Based Pharmacy Assistant & Clinical Unit Based Pharmacist Service Nambour General Hospital Key Performance Indicator % Discharge Medical Record 26% (Oct-Dec 2014) 50% % Medication Action Plan 46% (Oct-Dec 2014) 78% ipharmacy Interventions 3FE (12 in 6 weeks) 60 Pharmaceutical Review 3FE (60 in 6 weeks) 100% No. of Discharge Summaries with Pharmacist generated Medication Information No. of Discharge Summaries with No Medication Information 52.0% 100% 42% 0%
Key Changes Implemented Clinical Unit Based Pharmacist Service (CUBPS) Team Based Pharmacist Rounding with Medical Team Proactive and Point of Care Prescribing rather than reactive Timely preparation of MAPS and DMRs Education and Training of Junior Medical Staff 6
7 Key Changes Implemented Pharmacy Assistant allocated to the Clinical Area as part of the MDT to: Meet clinical requirements of the team Source Medication History Provide all medication including Imprest, Inpatient Supply and Discharge Prepare MAPs and DMRs (Authorised by Pharmacist) Facilitate controlled Drug Deliveries and Returns Reconcile Medication Drawers with National Inpatient Medication Chart (NIMC) Quarantine Ceased/Not required/patients Own Medication as required Communicate with nursing staff regarding status of Discharge scripts/inpatient supplies
2015 Confidential Draft Discussion Document 8 Outcomes so far Activity Nambour General Hospital All Areas (2 Feb. to 27 July 2015) Clinical Unit Based Pharmacy Service and Ward Based Pharmacy Assistant Med 1 Team (2 Feb. to 27 July 2015) Change DMR 35% 54% (KPI 50%) 19% MAP 61% 78% (KPI 78%) 17% No. of D/C Summaries with elms No. of D/C Summaries with No Medication Information 51% 79% (KPI 100%) 28% 44% 12% (KPI 0%) 32%
2015 Confidential Draft Discussion Document 9 Lessons Learnt It is possible to do BIG things with limited resources Redesign projects are possible if the enthusiasm and excitement is shared by the team To another organisation trying to implement the same innovation our advice would be Just do it! Where to from here : This Innovative Practice Initiative has now been endorsed by Executive and will set the benchmark for the Pharmacy service for the new Tertiary Hospital Sunshine Coast Public University Hospital Opening November 2016 This concept of Pharmacist as a member of the MDT has been endorsed by Society of Hospital Pharmacists as a position statement in June 2015
Contact for this Innovation For more information Contact: Liane Ward-Panckhurst Tel: 07 54706347 Email: liane.ward-panckhurst@health.qld.gov.au 2014 Confidential Draft Discussion Document 10