Of the digitisation projects ongoing at St Helens and Knowsley Teaching Hospitals (STHK) NHS Trust, electronic prescribing and medicines administration (EPMA) represents the biggest step forward for patient safety
STHK and EPMA, therefore, ensure that the right drugs get to the right patient at the right time.
When it comes to reducing prescription errors, a recent study by the universities
of York, Manchester and Sheffield reported that in England’s NHS alone some 237 million medication errors occur every year, which, as former Health Secretary Jeremy Hunt estimated, accounts for between four and five deaths a day.
Whilst the NHS is committed to reducing these errors by 50%, St Helens & Knowsley working with WellSky International (formerly known as JAC) have challenged themselves to achieve an even higher rate.
In April 2017, Whiston, an in-patient hospital, went live with WellSky’s web-based EPMA. In under a year, the Trust saw positive results by digitising medicines management. The system links with WellSky Pharmacy stock control module and together create an end-to-end integrated medicines management platform that can interface with their System C Patient Administration System for order communications, admissions/discharge and other functionality. This digital environment enables quick and easy data sharing across wards and other trust sites, providing nurses and doctors with secure access to patient records even while they are on the road.
Why WellSky? In addition to already having its pharmacy stock control system, the Trust wanted an electronic prescribing solution with broad functionality, designed by domain specialists and already with a proven user base. At the time of selection, the Trust didn’t have an electronic patient record (EPR) so were free to choose the EPMA market leader.
One of the main priorities was a modern web-based system that was intuitive to use for mobile clinicians and would be easy to deploy, upgrade and interface with other applications as our digitisation programme evolves.
EPMA’s web version updates are done directly from the IT centre with users accessing the system via URLs. Not only does this save a great deal of time, but it also ensures everyone is always using the same version.
The digital transformation
“The new system is much more efficient and quicker than other versions that I’ve used previously,” said Dr Andrew Hill, Clinical Lead for Stroke Services.
When WellSky EPMA was introduced to clinicians, the web interface – which was designed following an in-depth study of how users navigate screens – greatly simplified the training process.
In fact, the speed with which the Trust overcame cultural and technology barriers were especially impressive considering the complexity of electronic prescribing. There is a vast array of medicines, protocols and dose bandings to be custom configured into the drug database, along with exception alerts for the drug allergies and the special sensitivities of individual patients. Given that a single error can be life-threatening, this explains why medicines management has one of the lowest tolerances to error: It simply must be safe.
Eliminating transcription mistakes
“On electronic systems, you reduce the amount of hand-written transcription of medications; which significantly reduces the number of prescribing errors,” commented Dr Andrew Hill, Clinical Lead for Stroke Services.
Like all hospitals, the Trust used to have problems with the wrong medicines being delivered to the wards because of the order’s illegible handwriting. And while these were always spotted in time, it posed unnecessary risks. WellSky EPMA eliminates this risk.
Other safety features include decision support tools like best practice medicines and dosage defaults. By prescribing electronically, orders no longer go astray and drug administering schedules can be monitored and flagged up if a round is missed. And in cases when care is time-critical, a change in prescription or dosage can be reviewed and amended remotely in real-time. The Trust has noted a marked reduction in medicine incidents logged by the Datix incident reporting system.
Saving clinician time
With WellSky EPMA clinicians no longer wade through old kardexes to look up a patient’s medication history. Instead, doctors can see a patient’s complete real-time prescription sheet on a single consolidated screen; determine when a particular drug was last administered and find out why it was stopped. Because all medicines data is captured within the database, on readmission to the hospital a patient’s treatment history can be called up instantly. The pharmacy/treatment dispense information interface allows EPMA data to be downloaded to create discharge letters for the patient’s GP.
Digitising the Trust’s medicines management environment has also had a positive impact on operational and financial efficiencies. The wealth of data captured by the WellSky EPMA system is not only clinically rich but enables the generation of a wide range of reports and analysis of both clinical and operational outcomes in a way previously not possible. With future EPMA rollouts planned for
St Helens Hospital, outpatients and possible outreach into community hospitals, the project is nothing short of transformative.
*Please note: This is a commercial profile
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