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Medication Management Plan Implementation An Emergency Department - - PowerPoint PPT Presentation
Medication Management Plan Implementation An Emergency Department - - PowerPoint PPT Presentation
Medication Management Plan Implementation An Emergency Department Perspective Mixed Adult and Paediatric Major Urban 51000 presentations per year Approximately 150 patients per day 40% admission rate Jointly started by hospital pharmacy
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Jointly started by hospital pharmacy and ED Hospital wide short education sessions
including ED
Posters Intensive education sessions in Dec
2014/January 2015
Continuing posters/education session (but less
intensive)
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District Educator
- Interactive 20 minute session
- All ED doctors and nurses
- Daily sessions
HETI online module ED Staff specialist : JMO teaching session,
Registrar teaching session, Facebook page reminders, email reminders
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16 Dec 2014: 71% compliance with MMP Commitment by hospital pharmacy,
Emergency department and hospital executive to improve compliance with MMP
Education and senior buy in
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MMP added to JMO Ward checklist Directive from hospital executive that MMP
must be kept at the bedside
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Extension of what we should be doing anyway Advised staff to complete when they are
taking the history
Doubling up between MMP and medical
record
Allowed to use MMP only In practice written in both Does not take long
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Time to complete Senior buy in Nurses had difficulty getting medication lists
from GPs
Inpatient teams think it is ED’s job to do it
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100% compliance in February, 2015 In June, 2015, still >95% compliance Continuing education sessions
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Consultant checking on rounds Consultant sign off and Nursing sign off Regular teaching sessions for JMO/Registrar Emails and social media (Facebook page
reminders)
Pharmacist in ED checking All clinical staff are educated from district
educators
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MMP Policy Directive developed, approved by
Clinical Council and disseminated to staff
MMP Resource Folders Reference cards for MMP issued to clinical staff MMP Integration into existing QI initiatives eg
Patient Journey Boards
Process commences in ED for emergency
admissions and Pre-admission Clinic for elective surgical patients
Blue handover stickers for medical officers
amended to include MMP as a handover action
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Four consecutive audits were conducted from
December 2014 to February 2015.
Total of 401 MMPs captured Audit focused on use of MMP on admission
and BPMH
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73% 94% 98%
100%
10 20 30 40 50 60 70 80 90 100
16-Dec-14 28-Jan-15 04-Feb-15 10-Feb-15
% of patients with MMP
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39% 61% 87%
92%
10 20 30 40 50 60 70 80 90 100
16-Dec-14 28-Jan-15 4-Feb-15 10-Feb-15
% of patients
N1=87 N2=103 N3=105 N4= 106
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0% 20% 40% 60% 80% 100%
1
Percentage of MMPs initiated by profession
Pharmacist Medical Officer Nurse
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MMP included on Patient Journey Boards (PJB) –
Business Rules developed and implemented
MMP included in nursing clinical handover tools Peri-operative clinical handover document
includes MMP
Orientation programs reviewed to include MMP Pharmacists rostered to attend PJB rounds Pharmacists allocated pagers to facilitate their
attendance in PJB rounds
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Need senior ED clinical leadership Patient safety enhancement Not a massive change from current practice Collaborative approach between ED and
inpatient team
Regular reinforcement
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The MMP project won the South Western
Sydney Local health district quality award for 2015 for category of " Patient and carers as partners".
The title of the submission was " The new