Using MCAP to Understand Delays in Medication & Pharmacy - Liverpool Heart and Chest Hospital NHS Foundation Trust
ISSUE
MCAP data was used to identify delays in patients discharged home. Patients were being discharged later in the day due to medications not being dispensed in time.
SOLUTION
A pilot to test out an enhanced role for a pharmacy ward technician was undertaken on a 42-bedded Cardiology ward (Birch Ward) Monday to Friday. A Pharmacy Ward Technician was assigned to the ward in the mornings to pilot what tasks a pharmacy technician could undertake to reduce the delays in medications being dispensed in time for patients to be discharged home. Root cause analysis identified:
1. Medicines going missing.
2. The ward was not meeting NICE guidance for a medications review for a reviews undertaken within 24 hours.
3. Pharmacy staff were not included in the MDT process.
4. The number of phone calls from the ward to pharmacy chasing up TTO’s was significant
5. Re-dispensing medications for patients being transferred was resulting in associated wastage and cost implications.
OUTCOMES
1. A significant reduction in phone calls had a positive impact on freeing up valuable nursing time.
2. Urgent TTOs were prioritised by the technician and dealt with in a timely manner.
3. The pilot resulted in an increase in the number of patients discharged home before lunch.
4. Issues relating to medications were resolved quicker.
5. There was a significant reduction in the return of medications to pharmacy and the re-dispensing of medications (wastage). This would result in annual cost savings of just over £40k. Prior to the pilot, approximately 150 boxes of drugs were returned in a month.
6. There was a significant reduction in lost boxes of medications
7. Medically optimised patients requiring TTO’s reduced from 46% to 29% in a month.
8. Improved satisfaction of ward and pharmacy staff.