The Australian Commission on Safety and Quality in Health Care and the National E-Health Transition Authority (NEHTA) are working together to reduce medication errors in hospitals through safer electronic medication management systems in hospitals. In Australia, the term Electronic Medication Management (EMM) covers the whole hospital medication cycle including prescribing by doctors, dispensing by pharmacists, and administration of medications by nurses. The Australian Commission on Safety and Quality in Health Care and NEHTA are developing three guidelines to assist hospitals safely specify and implement EMM systems.
KPMG and Trilogy Information Systems have been engaged by the Commission to develop:
- User requirements and procurement guide for hospital EMM systems
- An implementation toolkit for hospitals
- An optimal look-and-feel user interface, building on the National Inpatient Medication Chart (NIMC).
The aims of the Project are to:
- reduce expensive and inefficient duplication specifying EMM systems and planning for implementation.
- optimise the safety and effectiveness of EMM systems implementation in hospitals
- minimise the danger of poorly designed or resourced implementations, and
- create a consistent 'look and feel' amongst EMM systems reducing risk of error from health professionals interacting with unfamiliar user interfaces.
The Commission is being advised on the project by a group of clinical and implementation experts including representatives from:
- Hospitals that have implemented electronic medication management systems
- National Prescribing Service Ltd
- National E-Health Transition Authority
- State and Territory health departments
The work started in August 2009 and the guidelines will be provided to the Commission and NEHTA for review in February 2010.
Further details
The most common medication errors in hospitals result from slips and lapses. Improving script legibility, dose calculation, the linking of laboratory results, and alerts for allergies and drug interactions should lead to a significant improvement in patient safety. Building protocols into systems will also strengthen prescribing consistency and best practice.
Typically, patients come to hospitals with a number of drugs already prescribed and, during their hospital stay, their medications are often modified. Heart patients, for example, could have new drugs added or doses modified. Prescribing for patients with diabetes and other chronic diseases means the heart, liver and kidneys need to be cautiously considered at the time of prescribing.
Doctors, nurses and hospital pharmacists hope that the move to legible prescriptions and standard dose units, linked to other information like laboratory results and allergy records, will make their work easier and, ultimately, result in safer patient care.
Many hospitals are already planning for implementation of EMM. However, while Australian hospital pharmacists have been managing inventories and dispensing with computer systems for some years, there are few examples of full EMM systems in Australian hospitals. Those involved in implementation projects invariably speak of critical success factors such as the changes to culture and practice, and the need for detailed planning. Reflecting this experience back into the guidelines as a learning exercise for other hospitals is critical.
Underlying the project is the idea that a lot of the complex work - developing tools to assess and procure EMM systems, building up a strong Implementation Planning Study and defining what an optimal EMM screen looks like - should be properly resourced to create a robust, adaptable toolkit for hospitals, rather than each centre starting from scratch.
Contact:
Neville Board, Information Strategy Manager
(02) 9263 3587
Email: mail@safetyandquality.gov.au
