Why we need to promote best practice standards of care for the management of medication

Latest figures for 2015/16 showed that on average 49,000 people attended A&E departments in England every day – in winter this figure rockets. Within this pressured environment, demands placed on healthcare professionals are huge.

Recent statistics show that in the 12-months leading up to September 2016, more than 190,000 medication errors involving the management of medication were reported in England to NHS National Reporting and Learning System (NRLS). These errors include; giving the wrong medicine, the wrong dose of the right medicine – or giving medicine to the wrong patient. The majority, nearly 150,000 were reported in UK hospitals.

Yet, technology exists via innovative digital dispensing and management systems which can dramatically reduce, if not eradicate, all these errors. It provides a valuable safety net for professionals working at the forefront of our NHS.

The increasing demand on the NHS will not subside and nor will the need for cost savings. Trusts and policy makers are now looking at new ways of working and turning to new technology in order to create a system that can cope efficiently with these pressures and deliver a world class service.

Omnicell UK & Ireland recently commissioned an independent ‘SAFE: Safeguard Against Frontline Errors’ authored by a leading independent pharmaceutical expert. The report found that within an A&E setting, ward-based pharmacy automated medicines cabinets result in a more efficient and reliable system for patients and staff. Automation has significantly helped A&E departments cope with winter pressures; NHS hospitals which have installed these systems have found that they;

• Improve patient safety: reducing incidents of missed doses
• Improve productivity and efficiency: reducing ad-hoc ordering, stock-outs and wastage and replacing CD paper registers. As well as cutting staff time searching for keys and topping-up ‘old fashioned’ medicine cupboards – meaning more time can be spent on patient care.
• Fuel much needed costs savings: reducing stock line, consumption & expiry losses
• Improve ‘swift and safe’ patient discharge: thereby reducing ‘bed-blocking’

Despite recent analysis and recommendations from NHS England’s Next Steps on the NHS Five Year Forward Plan (March 2017), the Lord Carter report and the subsequent CQC report into patient safety within the NHS, many hospitals are yet to automate their medication process. As winter approaches and pressures mount on A&E departments, nurses and frontline staff, medication-based automation needs to become a standard of care in A&E departments up and down the country.

There is a key role between the discharge process from A&E to the ward, particularly around medicines, which has not been designed for the extra demand that is now being placed on them. In short, poor medicines management from old systems and working practices hugely impacts A&E discharge times and the ‘flow’ of patients throughout a hospital with huge consequences. It is imperative that A&E staff have quick and easy access to medicines and are not diverted from clinical care to the logistics of medicines supply.  The SAFE report identified 5 key consequences of poor medicines management in this area;

1. Missing keys; finding medication cupboard keys wastes valuable time for staff and patients
2. Controlled Drugs Register: a full CD count has to be undertaken twice a day which is time consuming
3. Poor stock control: poor medicines handling results in over-stock and out of date stock and unnecessary waste
4. Poor discharge processes: patients are often made to wait to take home medication resulting in a poor flow of patients through the system
5. Lack of medication audit trail: the lack of audit trail of which drug, dose, patient, time and person administering can compromise safety through missed or repeated doses.

Automation creates a reliable system for administrating medicines to patients. It gives the reassurance that the right medicine is available for the right patient, at the right time. Nurses are able to log into the systems using a PIN code or fingerprint and are guided to the medication by a flashing light to the correct drawer. A full audit trail, in the event of a product recall, is available at the touch of a button.

Professor Sir Mike Richards, the Care Quality Commission’s Chief Inspector of Hospitals has recognised the need for innovation. “What is clear is that while staff continue to work hard to deliver good care, the model of acute care that once worked well cannot continue to meet the needs of today’s population. The NHS now stands on a burning platform – the need for change is clear,’’ he explained.

Transformational change, even in the most challenging of circumstances is possible to help deliver a world class health system.  We have worked with Trusts, nurses and pharmacists who have embraced new technology and improved patient experience and safety. The aim of this report together with the launch of our new ‘A&E Standard of Care booklet’ is to help the NHS share best practice and learnings from medication-based automation. This includes introducing efficiencies, to show how ward based technology provides a ‘safety net’ for healthcare professionals managing medicines and ensures quality care remains at the forefront of our NHS.

For free copy of the SAFE report or A&E Standard of Care booklet please contact: marketinguk@omnicell.com