Medication Management Plan Implementation An Emergency Department - PowerPoint PPT Presentation

Medication Management Plan Implementation An Emergency Department Perspective

Mixed Adult and Paediatric Major Urban 51000 presentations per year Approximately 150 patients per day 40% admission rate

 Jointly started by hospital pharmacy and ED  Hospital wide short education sessions including ED  Posters  Intensive education sessions in Dec 2014/January 2015  Continuing posters/education session (but less intensive)

 District Educator  Interactive 20 minute session  All ED doctors and nurses  Daily sessions  HETI online module  ED Staff specialist : JMO teaching session, Registrar teaching session, Facebook page reminders, email reminders

 16 Dec 2014: 71% compliance with MMP  Commitment by hospital pharmacy, Emergency department and hospital executive to improve compliance with MMP  Education and senior buy in

 MMP added to JMO Ward checklist  Directive from hospital executive that MMP must be kept at the bedside

 Extension of what we should be doing anyway  Advised staff to complete when they are taking the history  Doubling up between MMP and medical record  Allowed to use MMP only  In practice written in both  Does not take long

 Time to complete  Senior buy in  Nurses had difficulty getting medication lists from GPs  Inpatient teams think it is ED’s job to do it

 100% compliance in February, 2015  In June, 2015, still >95% compliance  Continuing education sessions

 Consultant checking on rounds  Consultant sign off and Nursing sign off  Regular teaching sessions for JMO/Registrar  Emails and social media (Facebook page reminders)  Pharmacist in ED checking  All clinical staff are educated from district educators

 MMP Policy Directive developed, approved by Clinical Council and disseminated to staff  MMP Resource Folders  Reference cards for MMP issued to clinical staff  MMP Integration into existing QI initiatives eg Patient Journey Boards  Process commences in ED for emergency admissions and Pre-admission Clinic for elective surgical patients  Blue handover stickers for medical officers amended to include MMP as a handover action

 Four consecutive audits were conducted from December 2014 to February 2015.  Total of 401 MMPs captured  Audit focused on use of MMP on admission and BPMH

100% 98% 100 94% 90 80 73% % of patients with MMP 70 60 50 40 30 20 10 0 16-Dec-14 28-Jan-15 04-Feb-15 10-Feb-15

100 92% 90 87% 80 70 % of patients 60 61% 50 40 N 1 =87 39% N 2 =103 30 N 3 =105 N 4 = 106 20 10 0 16-Dec-14 28-Jan-15 4-Feb-15 10-Feb-15

Percentage of MMPs initiated by profession Pharmacist 1 Medical Officer Nurse 0% 20% 40% 60% 80% 100%

 MMP included on Patient Journey Boards (PJB) – Business Rules developed and implemented  MMP included in nursing clinical handover tools  Peri-operative clinical handover document includes MMP  Orientation programs reviewed to include MMP  Pharmacists rostered to attend PJB rounds  Pharmacists allocated pagers to facilitate their attendance in PJB rounds

 Need senior ED clinical leadership  Patient safety enhancement  Not a massive change from current practice  Collaborative approach between ED and inpatient team  Regular reinforcement

 The MMP project won the South Western Sydney Local health district quality award for 2015 for category of " Patient and carers as partners".  The title of the submission was " The new multidisciplinary team : Doctors , pharmacists, nurses administrative staff and patients.