Reducing length of stay through medicines management interventions

1. Reducing length of stay through medicines management interventions Key Slides

2. Medicines management encompasses the entire way that medicines are selected, procured, delivered, prescribed, administered and reviewed to optimise the contribution that medicines make to producing desired outcomes of patients care. What is medicines management? A Spoonful of sugar. Medicines management in NHS Hospitals. The Audit Commission (2001)

3. Patient Increased morbidity Loss of autonomy Increased costs to patient and visitors Higher risk of hospital acquired infection Higher risk of adverse drug reaction NHS Additional use of NHS resources Greater risk of adverse events Adverse publicity Increased financial cost to Trust Payment by Results Bed occupancy Why is reducing length of stay important?

4. Maximising technical services • Stock management: Formulary enforcement • Electronic prescribing/ordering • Automation – in dispensary, at ward level • Satellite pharmacies • Correct dispensary skill mix • Use of patient’s own drugs (PODs) • Dispensing for discharge • Pre-packaged medicines for discharge • Weekend working/ 24 hour pharmacy • Motivation of staff

5. Clinical Interventions • Assertiveness • Medication history taking • Policy development and implementation • Prescribing and prescribing advice • Surgical interventions • Ward round participation • Palliative care interventions • Interface liaison

6. Reducing Harm • Adverse Drug Reactions (ADRs), Adverse Drug Events (ADEs) and Hospital-Acquired Infections (HAIs) can increase patient length of stay • ADRs are preventable in 50-70% of cases • ADEs are generally preventable through appropriate development and implementation of procedures • Pharmacists have a key role to play in reducing the incidence of hospital-acquired infection