Liz Kay, clinical director of medicines management and pharmacy services at Leeds Teaching Hospitals, discusses the introduction of new technology to speed up the dispensing of controlled drugs from a central pharmacy.
Pharmacy
All organisations are required to have governance arrangements in place to ensure the safe storage, management and use of controlled drugs in line with the Misuse of Drugs Act and the Controlled Drugs Regulations 2013. Now, new technology is helping pharmacy to manage controlled drugs safer and faster making a real difference to patients on controlled medication. The technology streamlines processes, replaces manual systems and improves the speed and efficiency of controlled drug management enabling compliance with the legislation.
At St James’ University Hospital, we issue 2,000 controlled drug items every month and we count the stock daily. Approximately 2,500 packs of controlled drugs are stocked within the pharmacy department which have a total value of £15k. On reviewing our processes we found that every day staff were spending three hours, almost half of their shift, making records in controlled drugs’ registers. In addition the dispensing process itself was time consuming with nine steps involved for the supply of each individual controlled drug. We recognised that these administration tasks, undertaken by our experienced team, represented time taken-away from patient facing activities – the central value of our profession.
Leeds Teaching Hospitals was looking for a solution that would automate the storage and supply of medicines within wards and departments and would significantly improve the efficiency, security and transparency of medicines management throughout our organisation. I believe that innovation through better technology will improve our processes and will bring better and safer patient care. This technology will help us in pharmacy deliver our goal; - the right drug for the right patient at the right time.
Healthcare can be seen to be frustratingly late to the digital party in comparison to other industries. Yet when the significant increase in workload occurring in the NHS, is considered, and the challenges within secondary care, it is essential we embrace new technology to help deliver more efficient services. Improved efficiency releases time for patient care and creates financial benefits for the health service as a whole. Technological change can improve patient safety, which must be at the top of every hospital’s agenda, and especially so when it comes to medication delivery and adherence.
The introduction of the Omnicell cabinet at St James’ University Hospital has resulted in a significant number of benefits. These include a now paperless process for supply of controlled drugs from the pharmacy, and this has halved the time taken in dispensing and accurately checking. The supply of one controlled drug item has reduced from six and a half minutes to three minutes, as well as creating a more “lean” dispensing process reducing from the nine previous steps to six. Since installing Omnicell, the Trust has made a cost saving of £29,000 in staff time as a result of no longer requiring one member of staff who has been redeployed to a vacant post
Paul O’Hanlon, managing director at Omnicell UK&I, a provider of medication and supply management solutions to the global healthcare market continued:
The same Omnicell controlled drugs solution used at Aintree Hospital in Liverpool was highlighted within the recent CQC’s Annual Report (July 2016) for best practice. “The nurse creates an order from the electronic prescribing system and this order passes electronically through pharmacy stock control and into the controlled drug register/Omnicell. Safeguards are in place to ensure that only authorised nurses can place orders and that orders are correct. There is a robust audit process to allow ward managers to know who in their teams is placing orders and how frequently.” The system not only showcases a simple and efficient process for administering the controlled drugs, but a safe and secure home for the drugs.
Using the cabinets allows medication to be administered in a much simpler and safer process, meaning that staff can dispense controlled drugs confidently and accurately. The cabinets are fingerprint sensitive so only registered staff can dispense the drugs. This also has improved the audit trail as the electronic register is date and time stamped and allows staff to identify and drill down into the detail of historical transactions, providing more detail that the paper register did and complying with wider DoH initiatives.
From the perspective of pharmacy teams and nurses working or considering a career in care, the good news is that the digitalisation of some services offers unparalleled opportunities to divert tedious administration time, back into face to face patient care. Technology is helping to deliver a 21st-century National Health Service.