Using xPIRT to Record Pharmacy Interventions: An Observational, Cross-Sectional and Retrospective Study

Abstract

Medication errors and omissions can potentially cause harm, prolong a hospital stay, lead to co-morbidities and even death. Pharmacy interventions (PI) ensure that these errors are identified and addressed, leading to improved patient safety and prescriber practice. Particularly in community hospitals, many only having general practitioners and not specialist doctors in their medical teams, PIs assume a strategic role. The PIs recorded throughout 8 months (between November 2021 and June 2022) in the community hospital wards in Powys, Wales, UK, using xPIRT (Pharmacy Intervention Recording Tool), a new pharmacy intervention record toolkit, were subjected to a retrospective analysis. The data were organised by location, drug, severity, acceptance, cost avoidance and intervention type. Significant prescribing errors were identified, which can potentially be different from those recorded in acute settings. Our results also informed on the need for integrated electronic prescribing systems paired with a PI recording tool to address effectively prescribing inaccuracies. Overall, this study was able to identify pharmacy teams as key to improve patient safety and care while contributing to significant cost-savings, through the recording of PI using xPIRT.

Improving the impact of pharmacy interventions in hospitals

“…The error severity and calculated cost-avoidance were based on the Enhancing the Quality of User Involved Care Planning study, CLEO scale and School of Health and Related Research, the University of Sheffield costavoidance model, as described in our previous article. 31 Overall, the PT satisfaction on this project, an important outcome measure, improved from the baseline of 2.5/5 to 4.9/5 stars, at PDSA cycle 2.…”

“…This not only improved extrinsic motivation but also improved team culture and project engagement, towards a continuous quality improvement. The error severity and calculated cost-avoidance were based on the Enhancing the Quality of User Involved Care Planning study, CLEO scale and School of Health and Related Research, the University of Sheffield cost-avoidance model, as described in our previous article 31…”

“…xPIRT toolkit has been used in all the community hospitals in Powys, beyond the dates recorded in this quality improvement report, as reported elsewhere. 31 The tool allowed to record data using cost-free Microsoft Apps, through a Microsoft Automate flow from data inserted on a Microsoft Forms, added to an editable Microsoft Lists and translated into real-time interactive infographics on a Microsoft Power BI dashboard. xPIRT can be easily adapted and embedded into medicines' safety standard operational procedures of any health setting that uses Microsoft Apps.…”

A health integrated platform for pharmacy clinical intervention data management and intelligent visual analytics and reporting

“…14 The use of the Power BI platform to create a pharmacist intervention dashboard has recently been reported with positive outcomes. 8 , 15…”

“…, 2 , 3 The documentation of pharmacist clinical interventions has mostly been through paper-based methods, electronic software such as Microsoft Excel® or Access®, in-house electronic documentation systems, website databases and within the electronic health record. 3 , 5 , 6 , 7 , 8 …”