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Using the ECS to Facilitate Medicines Reconciliation in Scheduled Care

Using the ECS to Facilitate Medicines Reconciliation in Scheduled Care

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Using the ECS to Facilitate Medicines Reconciliation in Scheduled Care

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  1. Using the ECS to Facilitate Medicines Reconciliation in Scheduled Care Alexa Wall, Pharmacy Manager, Monklands Hospital Dr Gregor Smith, Primary Care Medical Director Sean Brennan, Project Manager

  2. Project Outline • Test ECS in four clinical areas of planned care • Project end point 400 patients • Evaluate • Clinical benefits • Acceptability (staff, patient) • Assess impact on decisions and care • 75% (305 patients) ECS accessed • 100 records not accessed; range of reasons

  3. Comparison with Current Treatment • ECS reflected current treatment in 66% of patients • Drug missing 44.2% • Discontinued meds still on repeat list 33.7% • Different dose 11.5%

  4. Potential Impact • 22% (n=67) ECS contained additional information • No harm 65% (43) • Would require monitoring to confirm that resulted in no harm and / or required intervention to preclude harm 30% (20) • Would contribute to or result in temporary harm and require intervention 5% (3)

  5. Patient Management • In 7 cases patient management plan changed • Including • Referral to an anaesthetist • Alternative treatment prescribed • Discontinuation of interacting drugs

  6. Acceptability • All patients asked for consent before access; 1 refusal • 86% staff found ECS helped in medicines reconciliation process • 93% staff thought accessing ECS as part of reconciliation process would reduce time • 79% advocated use in all admissions and OPD appointments • Excellent understanding of governance arrangements surrounding use

  7. Audit of SCI Gateway Referrals

  8. Conclusion • ECS accessed in 75% of study group - 22% of accesses contained additional information • Resulting in prevention of harm in 23 patients • 7 patients resulted in change of management • Using the referral letter as a source of medicines information on admission carries a significant clinical risk

  9. Will this be available in other Boards? • Significant interest from other Boards and within QI community • Great deal of discussion around access to data for this purpose • Consultation now complete: overwhelming support to extend use • Implementation plan now being developed

  10. Using the ECS to Facilitate Medicines Reconciliation in Scheduled Care Alexa Wall, Pharmacy Manager, Monklands Hospital Dr Gregor Smith, Primary Care Medical Director Sean Brennan, Project Manager