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Penny Fletcher MSc MRPharmS IPresc Senior lead pharmacist Women and Children Project supervisor

Audit and re-audit of documentation of changes to medicines on discharge letters in paediatrics at St Mary’s Hospital. Penny Fletcher MSc MRPharmS IPresc Senior lead pharmacist Women and Children Project supervisor Data collected by E L Alford, Pharmacy student, 2010

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Penny Fletcher MSc MRPharmS IPresc Senior lead pharmacist Women and Children Project supervisor

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  1. Audit and re-audit of documentation of changes to medicines on discharge letters in paediatrics at St Mary’s Hospital Penny Fletcher MSc MRPharmS IPresc Senior lead pharmacist Women and Children Project supervisor Data collected by E L Alford, Pharmacy student, 2010 S Mesgarpour Pre-registration pharmacist, 2011

  2. Background • Primary care audits have suggested poor communication from hospital to GP • In particular low levels of information of new and changes to medicines

  3. Objectives • Measure communication of changes to medicines • Evaluate effect of “EDCv2” • Electronic discharge summary • (discharge prescription / GP letter)

  4. EDC

  5. EDC Prescription

  6. Standard • CQUIN • Commissioning for Quality and Innovation • 60% initially in 2010 • Reasons for new / changes to medicines documented • 80% by end March 2011 • Financial incentive

  7. Methods • Prospective data collection over 2 weeks (including weekends) • May 2010 • Data presented to paediatric team • EDCv2 implemented August 2010 • Repeat data collection over 2 weeks • January 2011

  8. Methods • Discharged patients identified from handover sheets each day • Drug charts and medical notes reviewed • Identify new medicines & changes • Review EDC for documentation of changes • Completed a data collection form • QA by senior pharmacist

  9. Exclusions • Hospital transfers • Bone marrow transplant • HIV • Oncology

  10. Results

  11. Results

  12. Discussion • Initial audit had a significant effect to raise profile of the need to complete EDCs • “Other” discharge letters also found • Culture change to use EDC • Automatic “initiation” as EDCv2 linked to ICHIS • Teaching at doctor induction re EDCv2 • And need to document changes

  13. Conclusions • Prior to EDC v2 CQUIN target not met • There was a significant increase in the number of children getting an EDC with version 2 • Further work needs to be done to achieve the target of 80% documentation of changes to medicines • Including role of pharmacist • Consider a mandatory indication field

  14. Any questions? • Acknowledgements: Data collected by: • Liz Alford, Pharmacy student, USA, 2010 • Sahar Mesgarpour Pre-registration pharmacist, 2011

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