You can reduce medication-related risks with the right data and systems, writes Gerard Stevens.
If the aged care industry were to make a to-do list now in direct response to the Royal Commission into Aged Care Quality and Safety, what action would be at the top?
Reducing the number of medication-related incidents would be my choice.
It would also be the choice of Professor Johanna Westbrook, director of the Centre for Health Systems and Safety Research at Macquarie University, who told the commission that errors associated with medication management were the most common complaint arising from residential aged care facilities.
In giving evidence, Prof Westbrook emphasised the need for better systems and greater coordination between pharmacists, GPs and nurses to improve medication safety.
She referred to a study she led that found aged care residents on average had nearly 10 discrepancies between the GP’s medication records and the records kept at the facility.
She also pointed at the continued reliance on fax to communicate resident medication charts between the facility and the community pharmacy.
Given that a lack of consistency, continuity or completeness in patient information can create an environment ripe for errors, it’s no surprise that the majority of medication incidents occur during transitions of care and changes to medication therapy.
In fact, relatively few of all medication incidents experienced by residents arise from errors generated by pharmacies.
I have been involved in two Federal Government-led projects that will help reduce this risk – electronic prescribing and the Pharmacist Shared Medicines List (PSML).
Electronic prescribing, also known as e-prescribing or paperless prescribing, enables electronic prescriptions as a legal form of prescription.
It promises to reduce the risk of medication errors with a single source of truth about patient profiles for healthcare professionals to review. That means less time is spent checking different sources of information and the risk of medication error is minimised.
This way, doctors, nurses, and pharmacists can spend more time on what they do best – ensuring the best healthcare possible.
Paperless prescribing will provide the resident’s care team with access to:
- accurate, real-time information
- streamlined communication
- improvements in efficiency
- continuity of medications, as the electronic medication chart acts as a valid script for up to four months.
There are also no physical storage requirements. These benefits ultimately lead to improved safety for the resident.
I’ve also been working with the Australian Digital Health Agency (ADHA) PSML (read about the launch here).
It’s an important development because it ensures that a person’s most accurate, complete and up-to-date medication profile is curated by the pharmacy and accessible by their healthcare team, improving the quality of care provided.
The purpose of the PSML is to capture information generated by pharmacists from a range of sources when curating patient medication profiles.
These include reconciled hospital discharge medicines lists, taking consumer histories, medication reviews or from medication profiles curated for clients using medication packs.
All healthcare providers want the best for the people they are looking after and key to this is having access to the most accurate and current information to support their clinical assessments and advice.
Being able to consult a PSML within My Health Record supports this by harnessing pharmacist skills to generate a complete and current medication list. Clinicians will have greater confidence that they have a full picture of what their patient is actually taking, as opposed to what they have been prescribed.
Importantly, this also includes non-PBS items, such as complementary and over-the-counter medicines like aspirin and ibuprofen. Previously these medicines have been difficult for clinicians to monitor and assess because of their widespread availability and use.
The ADHA plans to issue new professional guidelines for pharmacists on generating and uploading a PSML, along with information for other healthcare providers on what it is and how it is best utilised.
Find out more about PSML here.
Gerard Stevens is founder of Webstercare and inventor of the Webster-pak.
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