Matthew Webb1, Claire O’Connor1
1South Eastern Sydney Local Health District, Taren Point, Australia
In 2017, the South Eastern Sydney Local Health District Patient Safety Program published three documents to guide work on improving medication reconciliation processes. One noted that medication-related problems may contribute to hospital admissions in up to 12% of all medical admissions.
The Medication Safety Models of Care Working Party was created in response to these documents in 2018 and is sponsored by the Director of Allied Health. It supports the development of alternative models of care for pharmacy services in the Emergency Department (ED) and monitors progress of change initiatives relating to medication reconciliation in ED.
Change initiatives are focused on improving medication reconciliation for high risk patients who present to the ED and are admitted to hospital using a dedicated Pharmacy resource. Pharmacy services have identified several barriers that impact on fulfilling their scope of practice:
- Finite clinical pharmacy resources.
- No clear prioritisation process for clinical pharmacy services.
- A focus on medication reconciliation on discharge or part way through a patient admission when complications arise.
SESLHD is implementing 3 different models of care in the ED to support medication reconciliation for evaluation:
- Addition of a Pharmacy Technician in ED to support the existing Pharmacy service in
- Enhanced hours from existing Pharmacy workforce in ED to a 7 day service.
- Establishment of a new Pharmacy position in ED as a 5 day service.
These models aim to test which models have the greatest impact on medication safety and medication reconciliation rates in the organisation through early patient identification.
Outcomes to date:
- A standardised risk prioritisation criteria to assist ED Pharmacists identify high risk patients.
- ‘Entrustable Activities’ framework and training resources for Pharmacy Assistants/Technicians to enable them to support Pharmacists in Medication Reconciliation processes.
- Established pharmacy documentation standards in the electronic medical record which has led to improved visibility of Pharmacy Interventions within the multi-disciplinary team.
Matt works across all Allied Health Professions within SESLHD as an Educator, Data Manager and Workforce Consultant. He partners with managers and clinicians to improve and innovate their business, provide insight and enhance the delivery of services and outcomes to patients, carers and their families. Matt aims to engage, support and develop front line clinicians in the power of data analytics to transform clinical care.
His current projects include the evaluation of the locally developed BUILD Opportunities program for career development in early career Allied Health Professionals; and support the enhancement of Pharmacy clinical care provision in SESLHD Hospitals.