Implementing electronic medication management at an Australian teaching hospital

Day, Richard O.; Roffe, David; Richardson, Katrina L; Baysari, Melissa T.; Brennan, Nicholas; Beveridge, Sandy K.; Melocco, Teresa; Ainge, John; Westbrook, Johanna I.

doi:10.5694/mja11.10451

Cited by 18 publications

(18 citation statements)

References 9 publications

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“…Our qualitative studies at the study sites revealed clinicians' greatest concern regarding the introduction of e-prescribing systems was the associated work practice changes [46], and qualitative and observational studies may best identify the nature of these changes. Experience has shown that embedding systems into everyday practice is a long-term project [13]. Importantly, the results highlight the need to continually monitor and refine the design of these systems to increase their capacity to improve both the safety and appropriateness of medication use in hospitals.…”

Section: Discussionmentioning

confidence: 99%

“…There is little work comparing commercial systems or the interactions between system design and error rates and types, despite increasing concerns regarding new errors associated with their use [8],[10],[11]. Implementation of these organisation-wide clinical information systems is complex [12],[13] with a multitude of work process and cultural factors [14]–[16], which affect system adoption and use, driving both intended and unintended outcomes [10],[11],[17],[18].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study

et al. 2012

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“…Medication safety experts have seen eMM as a solution to medication safety problems for the 21st century [11]. However, the variety of eMM systems available attest to the fact that after two decades, there is not yet a perfect solution [23]. If electronic medication management is integrated effectively within existing systems, optimal prescribing, documentation and communication should occur, leading to seamless transitions between hospital and the home.…”

Section: Pharmacy Based Medication Safety Programs Preparing For Tmentioning

confidence: 99%

Medication Safety: Experiential Learning for Pharmacy Students and Staff in a Hospital Setting

Graudins

Dooley

2016

Pharmacy

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Medication Safety has been an established pharmacy specialty in Australian hospitals since the early 2000s and is now one of the ten Australian hospital accreditation standards. Although advances have occurred, medication-related patient harm has not been eradicated. Victorian undergraduate pharmacy programs include some aspects of medication safety, however clinical pharmacy experience, along with interpersonal and project management skills, are required to prepare pharmacists to be confident medication safety practitioners. This article outlines the range of medication safety-related training offered at an Australian tertiary teaching hospital, including; on-site tutorial for undergraduate students, experiential placement for pharmacy interns, orientation for pharmacy staff and resources for credentialing pharmacists for extended roles. Improvements continue to be made, such as electronic medication management systems, which increase the safe use of medications and facilitate patient care. Implementation and evaluation of these systems require medication safety expertise. Patients’ engaging in their own care is an acknowledged safety improvement strategy and is enhanced by pharmacist facilitation. Building educator skills and integrating experiential teaching with university curricula should ensure pharmacists have both the knowledge and experience early in their careers, in order to have a leading role in future medication management.

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“…In the Australian context, this has led to long lead times for adoption and post-go-live maturity 8. In Western Sydney, the experience of implementing EMR prior to EMM had ingrained a culture of digitisation and electronic documentation.…”

Section: Introductionmentioning

confidence: 99%

Patient-centric implementation of an electronic medication management system at a tertiary hospital in Western Sydney

Gunja¹,

Dunlop

Vaghasiya

et al. 2018

BMJ Health Care Inform

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BackgroundTraditional implementations of electronic medication management (EMM) systems have involved two common formats – a ‘big bang’ approach on the day of go-live, or a phased ward-by-ward approach over months.ObjectiveTo describe the patient-centric roll-out, a novel implementation model in converting from paper to EMM.MethodThis model iteratively converted a large tertiary teaching hospital to electronic from paper medication charts, commencing the roll-out in the emergency department (ED). The tenet of ‘one patient, one chart’ was maintained with new patients commenced on EMM, while existing inpatients were maintained on paper charts until their discharge. In the second week, all other intake points commenced patients on EMM, and in the third week, all remaining patients were manually converted to EMM. The implementation was assessed with training completion rates, staff satisfaction surveys, focus group interviews and incident logs.ResultsAt go-live, 79% of doctors, 68% of nurses and 90% of pharmacists were trained in the EMM system. The ED converted to electronic prescribing within 24 hours; by day 20, all patients were on EMM. Two hundred and thirty issues were logged, none critical, of which 22 were escalated. Of the 51,063 medications administered, there were 13 EMM-related clinical incidents including three double dosing errors, none of which led to an adverse event or death. Overall, 77% of staff surveyed were satisfied with the EMM implementation.ConclusionsThe patient-centric roll-out model represents an innovative and safe approach with a single medication chart reducing transcription and improved medication safety for the patient and the organisation.

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Implementing electronic medication management at an Australian teaching hospital

Cited by 18 publications

References 9 publications

Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study

Effects of Two Commercial Electronic Prescribing Systems on Prescribing Error Rates in Hospital In-Patients: A Before and After Study

Medication Safety: Experiential Learning for Pharmacy Students and Staff in a Hospital Setting

Patient-centric implementation of an electronic medication management system at a tertiary hospital in Western Sydney

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