Lancashire Teaching Hospitals streamlines its medication ordering

Lancashire Teaching Hospitals NHS Foundation Trust (LTH) has implemented an electronic prescription and medicine administration solution, with the aim to eliminate medication errors altogether. The solution has been successfully deployed and yielding positive results.

Following its analysis of existing paper-based medication workflows and processes, LTH’s Electronic Prescription and Medicine Administration (EPMA) team designed and implemented several features to streamline medication ordering and reduce the risk of prescribing incorrectly:

  • In LTH’s EPR, prescribing is not possible unless a prior allergy documentation has been completed. The EPR prompts the prescriber to document a patient’s allergies if not already done. When allergy information is modified, or additions made after medications are ordered, the system will perform a reverse-check to determine if there is any risk and displays alerts to clinicians if so.
  • The system will alert the prescriber if they attempt to order a medication that the patient is already on or is incompatible with another medication. Customised alerts were also developed.
  • Mandatory fields were implemented in the system to foster best practices e.g. indications, assessments and brand prescribing for certain medications at point of prescribing and second signature on high risk medications at the time of administration.
  • In addition, the team also configured several Order Sets for particular types of medications such as insulins and antibiotics or for particular medical conditions to further streamline the prescribing process. The Order Sets help guide the clinician on what is available to order in the Hospital’s formulary and is based on the Trust’s policies.
  • Other very helpful features developed in the EPR by the team, include Clinical Review Screens for complex medications such as Insulin, Anticoagulants, and Anti-infectives. These screens display relevant patient’s laboratory results, vital signs and medication order/dose information, all on a single screen.

While it has only been a few months since the Gynaecology ward at LTH has gone live with the Electronic Prescribing and Medicine Administration solution, the benefits are already seen: the care unit scored 100% in the recent anti-microbial stewardship audit!

“We have built a very robust system where safety has been the key focus which will reduce errors in prescribing and administration”, says Gareth Price, Chief Pharmacist at LTH.