Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Benefits of EPMA at QEH, Birmingham
Document related concepts
Transcript
Benefits of EPMA at QEH, Birmingham Asif Sarwar History of PICS at QEHB • 1,200 bedded tertiary referral and University teaching hospital • £545million new development opened June 2010 • EPMA across all in-patient beds – Not yet in A&E, theatres, dialysis From this to this using these Description Information Hospital 1200+ beds PICS Specialties 17 PICS registered users Weekly logins Peak concurrency >5000 3900 - 960 doctors - 2470 nurses 500+ Weekly prescriptions Weekly administrations 32,000 137,000 OPD episodes 10,000 per week Support people who work with medicines – “A guide on the side” EPMA provides us with: – Legible instructions – Reviewing medications history – Access to further information – Clear guidance on what to do next • Expert error detection – Rules based surveillance with alerts outside order entry – → Reduce errors of omission or commission Rules-based clinical decision support Prescribing • defaults • dose validations • interactions • drug • clinical condition • serological state • duration of scripts • by specialty where necessary External/Internal links Lab results Cross-Referencing PICS – a developing Electronic Clinical Record Laboratory Flow Sheets Fluid Balance Urinalysis Charts Infection Control Clinical Flags Operation Noting Physiological Observations Electronic observations charts Recognising and Responding to the Deteriorating Patient • Automated text messaging /pager alerting • Evaluation of the recognition of deteriorating patients • Can be linked into medication rules However... • It still requires human interactions IT related errors • Look-alike drugs • Picklist choice/keystroke errors • Alert fatigue • Workarounds What about pharmacy? • Reduced missed doses • Intervention logging • Records of drug histories • Warfarin alerts • High-risk drug flag • Formulary enforcement Its greater than the sum of its parts • Bee aware • E-transfer of discharge letters to GPs • 100% compliance with thrombosis assessment • Compliance with dementia screens • Barcode scanning of patients to confirm identity So what.... • Every click is auditable • Improved patient safety • Juniors at weekends don’t have to re-write charts; more time on actual patient care Clinical Dashboard Turning data into information Antibiotic - % Missed Doses Date A 15 April 2009 Pause function for doctors B 04 August 2009 15 December 2009 24 February 2010 30 March 2010 Missed Doses go live on clinical dashboard C D * D * Step change in % missed doses when information shared with clinicians / managers Further highly significant change when CEO started RCA meetings Intervention Introduction of coloured indicators to show due / overdue drugs NPSA Rapid Response Alert Chief Executive Missed Dose Root Cause Analysis meetings Thank you – Any Questions?
