SLIDE 1
E-Meds in ED
Lynne Keith ED Educator/Clinical Informatics analyst
SLIDE 2
- Major Tertiary Health Provider in Northeast
Melbourne
- 3 Campuses
- The Austin Hospital
- Heidelberg Repatriation Hospital
- Royal Talbot Rehabilitation Centre
- Major Services
- Liver and Gastro-Intestinal Transplantation
- Spinal Cord Injuries
- Oncology
- Victorian Respiratory Services
- Olivia Newton John Cancer Centre
SLIDE 3 93,000 Inpatient Admissions 900 Beds 176,000 Outpatients 8,000 staff 50 bed Emergency department 83,000 Emergency Attendances annually
presentations daily Adult and paediatric Emergency service
SLIDE 4 E-Med implementation to ED April 2013
Scope: Inclusion
- Oral medications
- Short Infusions – eg IV antibiotics, amiodarone
- Paediatric meds
- Nurse initiated meds
- Discharge scripts
Policy to clearly define what is out and what is in Exclusions
- Continuous infusions : (One order = one bag)
- Blood products
SLIDE 5 E-Med implementation to ED April 2013
Implementation
- Devices one per clinician implemented 6 weeks prior to go live
- Go live day at 0800 paper medication charts removed
- Progressive go live only new presenting patients commenced on
E-Meds
- At the elbow support for clinicians by clinicians
- 24hr support
- Designated command center to manage and solve evolving issues
SLIDE 6
Benefits-clear legible orders
SLIDE 7
Benefits- Pre-Built Order Sentences
SLIDE 8
Benefits- Decision support
SLIDE 9 Benefits- antimicrobial prescribing guidance
Entering an Approval Number is Mandatory
SLIDE 10
Benefits- SSW pathways
SLIDE 11
Benefits- Quick orders
SLIDE 12
Benefits- Transparency in Med admin/orders
SLIDE 13 Benefits
- Significant decrease in error prone abbreviations on
discharge prescriptions from 47.7 to 7.2 (per 100
- rders)
- Improved consistency between the discharge
medication regimen and the discharge summary sent to the GP
- Significant reduction in information that needed to
be corrected/added to a prescription to ensure reimbursement by Medicare Australia
- No increase in prescribing time for consultants in ED
fast track
- Rate of update 95% for Inpatient Discharge
prescribing
SLIDE 14 Benefits
- No wasting time looking for drug charts
- Clear administration instructions- better
patient care
- Reference text available for all ordered
medications
- Supports streamline PBS authority
- PBS information available in prescribing
screens
SLIDE 15
Challenges-care sets
SLIDE 16
Challenges- Scheduled Meds
SLIDE 17
Challenges- nurse initiated analgesia
SLIDE 18 Clinical adoption success factors
- Staff engaged in Change process and established their prescribing
requirements in the system
- Right devices at the right time- one per clinician
- 100% training required and achieved either face to face or e-
learning
- 24hr support for 2 weeks post go live
- Super users were ED doctors /nurses/pharmacists
- Follow-up with any queries and address issues
