SCOTTISH HOSPITAL NEWS
INSPIRATIONAL TEAM EFFORT BOOSTS PATIENT OUTCOMES
A GREAT INITIATIVE BY A MULTI-DISCIPLINARY NHS TAYSIDE TEAM HAS PRODUCED UNPARALLELED BENEFITS FOR PATIENTS.
The future of technology in healthcare has been well and truly embraced by the NHS Tayside Pharmacy on call team, which has developed the ’on call app’, a tool which is available on two of the major handheld device operating systems android and iOS.
The current on call team was initially formed during the review of the service under the new harmonised Agenda for Change terms and conditions for on call. During this review, adherence to the European Work Time Directive was explored with specifi c reference to compensatory rest, and this resulted in a redesign of the service in order to comply with the directive. Given that the on call service had been provided the same way for many years in NHS Tayside, this represented a major change to the service. At the same time a strategic decision was taken to include Band 6 and 7 Pharmacists across the service as the cohort of
staff to provide the pharmacy on call service in NHS Tayside. In order to maintain suffi cient staffi ng, the on call services across Tayside were merged and centralised to create one single on call rota for the whole of NHS Tayside where there had previously been individual rotas for each hospital site. Initially, these changes were led by senior management within the pharmacy department. However it was recognised that engagement with the staff to provide the service was key to embrace the changes and make the implementation successful.
The wholesale changes to the way in which the on call service was delivered could have had a detrimental effect upon the team providing it, and also to the service itself. However, what actually resulted from these changes was a new era for the pharmacy on call service in NHS Tayside, where the team, made up of junior rotational pharmacists, took ownership of the service; setting its own goals and addressing issues that affected the on call service.
One great example of the service that this team now provides came one Friday afternoon at around 5pm, when it came to the attention of the on call pharmacist that there
was a patient on the ophthalmology ward who required amphotericin eye drops. It was the Easter weekend and there was no stock in Tayside. The request for the eye drops was urgent, as the risk of the patient losing their sight signifi cantly increased without the drops. After many calls to manufacturing units in England and Scotland – without success - the on call pharmacist phoned the general manager of the manufacturing unit located within Ninewells Hospital (Tayside Pharmaceuticals) to discuss the feasibility of producing the eye drops himself. After a lengthy discussion, the on call pharmacist decided this was the most appropriate course of action. The general manager of TP had a formula for the production of the drops and, using this, the on call pharmacist prepared the amphotericin eye drops within the aseptic unit of Ninewells hospital and delivered them to the ward. This is a great example of the absolute commitment within the on call team to do the very best for the patient even in challenging circumstances.
The initiative, which has had the biggest impact upon the service to the patients is the implementation of the ‘on call app’, which was developed in NHS Tayside by one of the team members who had a particular interest in this fi eld. He was able to follow up his idea and worked with a company to develop the app from scratch. The overall aim of the app was to improve the recording, searchability, ease of review and communication of the on calls that the team receives. The app has allowed the NHS Tayside pharmacy on call service to build a database of calls which can be communicated, searched, interrogated for trends and used for training. The main benefi ts of this include:
All activity from the pharmacy on call perspective can be identifi ed and addressed, meaning that the quality of advice on any given day doesn’t vary between different
RAPID TEST FOR BACTERIAL INFECTION REDUCES ANTIBIOTIC USE
Researchers from the Oxford University Clinical Research unit in Vietnam have shown that using a rapid (fi ve-minute) test can reduce antibiotic misuse for respiratory infections.
The study team made the tests available at ten primary healthcare centres in and around Hanoi, Vietnam, and recorded antibiotic use for 2000 patients who randomly were or were not tested for CRP. The results showed a signifi cant reduction of antibiotic use in adults and children while clinical recovery was the same. This trial was the fi rst to investigate this in a resource-constrained setting and showed similar results to trials in Europe. This was also the fi rst trial to assess CRP tests for children.
on call pharmacists resulting in constant high quality advice, including prescribing advice.
Better communication of issues, which need to be passed on to the day team the following day, resulting in better continuity of care and therefore better patient safety.
The ability to identify recurring themes and implement a solution to them. This can improve prescribing by preventing a problem before it has occurred due learning gained from past experiences.
The beauty of the app is that it can be adjusted for any health board. NHS Grampian has already started to use it and it has the potential to soon be used across the whole of Scotland. In this way, the work that was put in by one enthusiastic member of the on call team in NHS Tayside could result in improved prescribing and patient safety throughout the whole of Scotland. Sterling work!
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