SCOTTISH HOSPITAL NEWS
COLLABORATIVE WORKING AND EXCELLENT LINES OF COMMUNICATION BETWEEN HEALTHCARE STAFF CAN OFTEN BE THE KEY TO OPTIMUM PATIENT OUTCOMES. SP LOOKS AT THE EXCELLENT WORK PRACTICES OF THE PHARMACY TEAM AT DUMFRIES AND GALLOWAY HOSPITAL.
JOINED-UP APPROACH PROVES SUCCESSFUL IN DUMFRIES AND GALLOWAY
Around 280 deaths in Scottish hospitals each year are linked with medicines. Many of these deaths are preventable and, for that reason, the pharmacy team at Dumfries and Galloway Royal Infirmary have spent much of the last few years establishing systems and redesigning their roles in order to help reduce medicine-related deaths.
‘Good communication between various strands of the hospital team are vital to achieve optimum patient outcomes,’ says Pharmacist Team Leader – Clinical Services, Susan Roberts. ‘So, a couple of years ago, the hospital’s communication model was reviewed and improved and, as a result, pharmacy started to attend the whole hospital ‘huddle’.
‘This means that, each weekday morning, the senior pharmacy technician visits the whole hospital huddle and from this meeting she establishes capacity issues in the hospital and therefore likely workload pressures for pharmacy. This information is then passed onto to each of the clinical teams and the dispensary. This allows the required workforce with the correct skills to be allocated to high pressure areas pre-empting surge issues and therefore reducing stress on staff and contributing to a good flow of patients through the organisation.
‘The clinical team has also improved its communication at ward level.
We introduced, for example, an electronic system for collating and communicating clinical pharmacy information. This system allows the clinical pharmacists to allocate a triage category to patients as they are assessed on admission. Clinical pharmacists can also document any actions they have undertaken within the system or request colleagues to follow up pharmaceutical care issues. This allows team members further downstream to prioritise which patients they review and provides them with the information to target their actions. The pharmacy technicians also use this system to highlight any issues they identify when reviewing patients on admission (eg, medicines reconciliation discrepancies) to their clinical pharmacy colleagues.
‘The senior pharmacy team (including senior staff from aseptic, dispensary, distribution and clinical services) ‘huddle’ for a debrief of the preceding week and to plan for the following week. We start by sharing our high and low points of the week and any subsequent issues that need addressed. Once a month, the same team meets for an hour for a longer planning meeting. At this session we plan and agree actions for recruitment, service improvement and particularly planning for our move to a new hospital.
‘Once each month we also hold a fifteen-minute department
meeting where all staff are invited to ensure cascade of information both from and to the senior team.
Improving this flow of information around our team has allowed us to optimise the potential of our team resulting in improved patient care. We work well as a team as we communicate in an open, honest and constructive manner. All members are willing to share their ideas and experiences, confident that they will be considered fairly by the rest of the team. The team are aware of our strengths and weaknesses and we utilise each of our strengths depending on the task to be undertaken.
‘This is how we utilised the skills of each staff group…
‘Pharmacy assistants: Pharmacy assistants’ skills ensure the right medicine is supplied to the patient at the right time. Releasing time from a department-based role to a ward-based one allows them to use these skills to support the accurate flow of patients and their medicines around the hospital, which, in turn, releases pharmacy technician time.
‘Pharmacy technicians: The pharmacy technician’s role in Dumfries and Galloway is becoming more clinical. Technicians’ jobs and training require them to be methodical, organised and have a strong attention to detail. They have a deep knowledge of names, formulation and strengths
of the medicines held by pharmacy and the legal requirements of prescriptions. Technicians are experts in ensuring the medicine prescribed for that patient is the medicine supplied. They are able to review several sources of medicines information for a patient, ideally including the patient themselves, and identify any discrepancies. These skills mean the pharmacy technician is capable of much more than dispensing medicines.
‘The technicians use electronic solutions to communicate information to the wider team as well as using their skills in the ward environment. The pharmacy technicians have all been very keen to use their skills in this developed role and have participated willingly and enthusiastically to our ongoing work. Again, this contributes to optimal patient flow within the organisation, supporting pharmacists in their quest to provide a more clinical role.
‘Pharmacists: Pharmacists’ clinical skills are best utilised in ensuring the individual patient is prescribed the most appropriate medicines for them. The challenge over the last few years has been to achieve this whilst maintaining the flow of patients through the organisation, so the pharmacists implemented an electronic system to triage patients and communicate information to their colleagues and so improve the team efficiency within the resource available.
‘Overall, the rate of change has been dramatic, however the pharmacy team continues to maintain a professional approach and a seemingly endless energy to improve patient care.’ •
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