Closing the loop: Clinical prioritisation to improve patients’ medicines experience

Context

The introduction of the electronic prescribing and medicines optimisation (EPMA) system three years ago dramatically changed how clinical pharmacy services operate at our General District Hospital. The EPMA software installed in our Trust (v22020.4SP4) lacks the necessary features to fully support the delivery of clinical pharmacy services. Furthermore, there is limited published guidance to assist clinical digital teams or pharmacy leadership teams in developing effective clinical patient prioritisation dashboards for the transition from paper to digital workflows and achieving digital maturity.

Problem

Our digital journey began by learning from other hospitals using the same EPMA solution. The challenge we experienced in our pharmacy clinical teams was the reliance on multiple platforms to perform daily medicines optimisation tasks. This fragmentation hinders focus and efficient time management.

Assessment of the problem

Through increased digital maturity and a continuous learning process, the pharmacy leadership team decided to pursue the development of its own first in-house pharmacy clinical report including clinical parameters from other different clinical solutions by using a Business Intelligence (BI) reporting system (IRIS).

Intervention

The new pharmacy report was designed as patient-centred, prioritising clinical tasks from admission to discharge. It is divided into four sections: 1) patient demographics and location; 2) medicines reconciliation with three prioritisation levels and drug status orders; 3) clinical features such as AKI alerts and high-risk medication alerts; and 4) patient flow information including estimated date of discharge, discharge letter status, and potential blister pack requirements.

Strategy for change 

The design and development of the report took three months. The project did not require ethical approval. The report was demonstrated to pharmacy teams and supported with two further training sessions to prepare staff for the change.

Measurement of improvement

A staff survey was developed and agreed by the leadership team to assess our digital maturity and the use of BI reporting among pharmacists and Medicines Management Technicians (MMTs).

Effect of the change

The pharmacy report enables clinical teams to prioritise and allocate resources based on clinical need and risk for over 200 patients daily. This represents a shift from the previous “review all patients daily” model to a more prioritised approach. The survey results (n=14) and post-implementation experience indicate that the majority (64%) of respondents found the report useful. While 50% found it easy to filter and prioritise tasks, 36% found it challenging. Additionally, 43% perceived the report as a positive step in digitalisation.

Conclusion

Leveraging business intelligence reports and understanding effective digital maturity empowers clinical pharmacy teams to develop tailored clinical tools, enhancing processes, bridging gaps in EPMA systems and improving patient safety.

Additional authors: Gareth Hughes, Nisha Pounj-Taylor, Umar Patel

The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.