IMPLEMENTING EPMA

Experience at Kings College

Hospital

Caroline AndersonPrincipal Pharmacist

EPMANovember 2009

King’s - Overview

• EPMA system = iSOFT iCM• EPMA integral to EPR system• Joint pharmacy & ICT project• Multidisciplinary Project Board• Pilot started November 08• Roll-out completed on 6 wards• Expansion of the EPMA team to meet

roll-out demands

Choosing a Pilot Area

Range of users & process

Diversity of prescribing

User ‘buy-in’ & enthusiasm

Rate of patient

turnover

Complete patient journey

Practical consideration

s

Key considerations

King’s Choice

GENERAL MEDICINE

Pre-pilot Assessment

• Types of drug charts used• Commonly prescribed items & particulars• Identify ward staff and visiting teams• Timings of shifts, visits and drug rounds• Identify regular ward or team meetings• Drug trolleys, POD lockers or both• Hardware, network and software• Gauge what users want & expect

Hardware

Pre-pilot Audits

RISK• Prescribing

standards• Error rates• Missed doses• Allergy recording

PROCESS• Time taken to

prescribe • Length of drug

rounds• Finding drug charts

Training• Identify different user-groups• Design and compile different lesson plans• Training documentation and user guides• Dedicated training rooms• Pre-training training (e.g. Computer skills)• Scheduling staff • ‘Ad hoc’ and emergency training• Video scripts and intranet links

**Maintenance**

Transcription Process

The first 'e-drug round'

Support

Consolidation

PL

AN

NIN

GS

UP

PO

RT

Go-live

Meet Ward Manager & agree 'Go-live date'

Launch' meetings for ward staff

Commence training

Getting to and past ‘Go-live’

‘Go-Live’

PLANNING

TRAINING

MAINTENANCE

SUPPORT

= GO-LIVE

• 18 month Trust roll-out plan• Aiming for 2 wards per month• Additional time allowance for

complex areas (e.g. A&E, Critical Care, Specialist Medicine)

• Current plan excludes Paediatrics

ON TARGET!

King’s roll-out plan

Continuing Development

DRUG CATALOGUE ENHANCEMENTS

• Review configuration of all items

• Additional items• Drug-specific

information• Order-sets

USING NEW FUNCTIONALITIE

S• Allergy checking• Duplicate checking• Dose-calculation

forms• Reports

OTHER: Reports, audit, additional training documentation, super-users, sharing

experiences

Any Questions?

carolineanderson1@nhs.net