Torbay and South Devon NHS Foundation Trust delivers acute care at Torbay Hospital and runs five community hospitals. It provides health and social care to the local population of 375,000 residents and over 100,000 holiday visitors each year.
The Challenge
The NHS Long Term plan states that over the next five years, all providers will be expected to implement ePMA systems to reduce medication errors by up to 30%. With this in mind, and with a core need to provide safe medications prescribing throughout the whole integrated care organisation, Torbay and South Devon wanted a solution that was able to meet the urgent needs of both acute and community wards now, whilst being capable of expanding into primary care when needed.
The Solution
After a full OJEU competitive tender, the Dedalus ePMA system was selected and has now been deployed across key acute and community wards.
Dr Joanne Watson, System Medical Director said “Our ePMA is being used across both acute and community care settings and we want it to integrate with our GPs. One of the reasons we chose Dedalus was their commitment to working with primary care and their alignment with our strategy of full integration and the move towards becoming paperless”.
The initial roll-out, which took place at the end of January, covered six medical wards, one ambulatory unit and two emergency admissions units. The implementation over a weekend by a dedicated team consisting of IT support, trainers, Dedalus staff and clinicians. System Medical Director, Dr Joanne Watson oversaw and directed the project.
With over 1,750 staff trained and the Institute for Healthcare QI Methodology employed prior to the roll-out, the Trust were confident they had an ePMA system that was acceptable to staff and had worked out how to incorporate it smoothly into the complicated daily practices of the wards.
As Gill Otway, IT Programme Manager mentioned “The preparation for the roll-out was very thorough with as much clinical process evaluation, system configuration and pre-event training done as possible – although some training still inevitably had to be done during the weekend for bank nurses etc. It was a superb team effort with all key staff well prepared in advance and the wards fully expecting and ready for the change. Plus, there was a lot of behind-the-scenes support of our ePMA in Procurement and from Mike Green our CCIO.”
The results so far
The system now is being used in earnest by Pharmacists, Nurses, Doctors of all grades and other ward staff. It is already improving clinical processes by enforcing failsafe reviews at the correct times (which paper charts are not able to do) and ensuring prescribing accuracy.
The Dedalus ePMA system has been deployed on both tablets and laptops for use at the bedside and on the drugs trolley. And whilst tablets tested high on usability prior to roll-out, operationally it was found that the nurses preferred laptops. The solution comes with the NHS dm+d (dictionary of medicines and devices) catalogue as native. This, now mandatory, standard ensures the safe and reliable transfer of medicines information between clinical systems and cross-care settings.
At Torbay and South Devon, the ePMA system is directly linked to the Trust’s own Infoflex system for inputting accurate drugs information directly into the discharge summaries for GPs. Feedback from Dr John McCormick, a local GP with a lot of interaction with the Trust and Chief Clinical Information Officer at Devon CCG, has already noted that the implementation has made a ‘noticeable positive difference’ to the information coming out of the Trust, which is now much more comprehensive with clearer medications data.
Next steps
Dr Watson, added; “The initial roll-out was a brilliant team effort and has been such a success that we are already expanding into our two adult cancer wards and our other community hospital wards.” The plan is to follow with the surgical wards by the end of June and full Trust roll-out in August – in time for the annual change of new Doctors.
“Electronic prescribing and medicines administration is the way of the future – it brings benefits to the whole of the system,” adds Joanne Watson. “Not only can we reduce medication errors but we can also take more efficient control of pharmacy and formulary stocks to reduce costs. And by stimulating a more efficient discharge of patients and supplying GPs with complete drugs and treatment information, we can begin to avoid unnecessary readmissions.”
