E-Meds in ED...2016/04/01 · E-Med implementation to ED April 2013 Scope: Inclusion • Oral...
Transcript of E-Meds in ED...2016/04/01 · E-Med implementation to ED April 2013 Scope: Inclusion • Oral...
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E-Meds in ED
Lynne Keith ED Educator/Clinical Informatics analyst
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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
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93,000 Inpatient Admissions 900 Beds 176,000 Outpatients 8,000 staff 50 bed Emergency department 83,000 Emergency Attendances
annually Approx. 230 Emergency
presentations daily Adult and paediatric Emergency
service
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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
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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
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Benefits-clear legible orders
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Benefits- Pre-Built Order Sentences
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Benefits- Decision support
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Benefits- antimicrobial prescribing guidance
Entering an Approval Number is Mandatory
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Benefits- SSW pathways
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Benefits- Quick orders
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Benefits- Transparency in Med admin/orders
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Benefits • Significant decrease in error prone abbreviations on
discharge prescriptions from 47.7 to 7.2 (per 100 orders)
• 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
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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
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Challenges-care sets
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Challenges- Scheduled Meds
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Challenges- nurse initiated analgesia
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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