3
Introduction
• SUHT local hospital care– 500,000 people
• Regional Services ~3 million – Neurosciences– Cardiac– Children’s Intensive Care
4
Introduction
• Pharmacy Service– 250 staff– 3 dispensaries (2 sites)– 35-40,000 items/month
• Clinical pharmacy service– Specialist pharmacists– Ward rounds
5
Introduction
• Discharge summary• Carbonized A4 form
– Illegible, unclear– GP transfer via post or patient– Pharmacy unaware completed
• Local initiatives• New standards
7
Aim
• Design and deliver an IT application provide a complete legible and timely discharge summary– Multi-disciplinary– Electronic ordering direct to pharmacy– Improve discharge information received
by GP’s in clarity and time
8
Method
• Project Team – Multi-disciplinary• Current document
– Informal discussions– Medical– Pharmacy – Nursing and admin staff
• Wish list
9
Method
• Bespoke design– Data extract-drugs name,form,regimes– Drug package/order sentences– Controlled drugs– Pharmacy roles– Logic rules - pharmacy exceptions– Dispensary/Ward work lists– Security
10
Method
• Version 1– Acute Medical Unit (AMU)pilot - 2007
• Version 2– AMU, Medicine and Elderly Care
• Design– e-Learning package: doctors induction
11
Results
• Since pilot in 2007, e-Discharge trust widee-Discharge Summary Count
0
1000
2000
3000
4000
5000
6000
7000
Apr-0
7
Jul-0
7
Oct-0
7
Jan-
08
Apr-0
8
Jul-0
8
Oct-0
8
Jan-
09
Apr-0
9
Jul-0
9
Oct-0
9
Jan-
10
Apr-1
0
Jul-1
0
Month
Vo
lum
e
13
Work list
• Dispensary specific– Pharmacist screened documents appear in any
one of three dispensaries
© Ascribe Ltd
14
Security
• Role specific access– Doctors– Pharmacist, MM technicians– Nurses, administration staff
• Password• PIN
15
Information transfer
• e-Discharge Summary transfer– Hampshire Health Record (HHR)– 24 hours post patient discharge
• Direct transfer to GP surgery– 30-40 surgeries
16
Discussion
• e-Discharge system SUHT• e-learning training• Benefits
– Patient– Pharmacy– Medical– Nursing and administration staff – GP’s
• Financial/Clinical reporting and audit
17
Discussion
Issues• Time consuming
– Order sentences, drug packages– Common diagnoses lists specific to the
clinical specialty
• Transfer issues– Hampshire Health Record (HHR)– GP direct
18
Lessons learnt…
• Multi-disciplinary– Nursing staff
• Senior support– Big stick approach!
• Communication– Junior medical staff
• Hardware
19
Conclusion
• e-Discharge Summary– Reduction in illegible discharge
summaries.– Improved work flow into pharmacy.– Transformed access throughout Trust to
information on discharge summaries.– Improved GP transfer of information.
20
The future
• Work– Outpatient module– Medicines reconciliation– Anti-coagulation ~ warfarin– DVT prophylaxis recording– Repeat Prescriptions