SCOTTISH HOSPITAL NEWS


CHANGE TO WORK PATTERN PROVES MAJOR SUCCESS


As with most hospital pharmacy departments, the team at Borders General Hospital are constantly under pressure with a steady workload. In addition to working out on the wards as part of the ward teams, the Pharmacy Aseptic team comprising accountable pharmacist, Eileen Nicol, Lead Aseptic Technician, Anne McCombe and Deputy Accountable and Clinical Pharmacist, Fiona Bathgate, also work within the dispensary, covering duties as supervision of controlled drugs.


Last year, the team identified that, by clinically prioritising workload on a daily basis, they would be able to review their staffing requirements on a daily and weekly basis.


As a result, the team adopted a new rota and changed their work pattern with the aim of structuring and concentrating work within set time frames for the Central Intravenous Additive Service (CIAS) part of the service.


This change in the team’s work pattern has resulted in less downtime in between work items while awaiting the arrival of prescriptions and this time is now proactively used by the team to enable them to help out in other areas of pharmacy service provision.


To date, staff have engaged well with the changes and have shown themselves willing to participate in the challenges that such changes invariably bring. Flexibility has been very much the name of the game and has helped to make the changes a success.


One new objective that has also been met by the team is focussed on the support for a Saturday infusion clinic. The creation of this clinic has had a very positive impact on the hospital’s neurology and rheumatology patients, who, previously, would have had to travel to Edinburgh every two weeks: a minimum of a two-hour round trip.


Thanks to the establishment of the Saturday clinic, the patients can now be treated much closer to home, reducing the impact on both themselves, their families and carers during the week. Rheumatology patients in particular are benefiting from the Saturday clinic since many work full time and previously would have had to take time off for their infusions.


The changes in the work pattern have also brought benefits to the local cancer centre. To minimise disruption to patient care within the Macmillan unit and to decrease delays to treatments, the aseptics


team have rearranged pharmacy staffing to ensure that a member of staff is now available to deliver to the unit as soon as medication is ready.


This means that, if a patient is to receive three or four IV preparations in one day, the first one is made and delivered before the others to allow the Macmillan unit to start treatment without delay, and enables the patient to start treatment as soon as the first medication is ready, rather than have to wait for all medicines to be made.


In addition to the new Saturday clinic and the cancer centre, the staff time that the aseptic team’s changes released have been used productively in training individuals or in releasing staff to support other areas of the department during busy periods.


This training time has included up- skilling members of the technician team to complete tray checks, thereby reducing the time of other staff needing to go in and out of the aspetics unit to complete this task.


Another change initiated in the work pattern was the introduction of antibiotics being made up for the wards on a twice daily basis (morning and afternoon sessions in aseptics). This provides extra support for the wards and means that antibiotics


are now made in time for lunchtime doses.


This move was especially beneficial to patients since, previously, when medicines were made during the morning session, there was always a chance that the medicines could be reviewed on the ward round that morning and subsequently discontinued after it had been prepared in aseptics.


By changing the working pattern in aseptics to making such medicines in the afternoon, this meant that, once patients had been reviewed on the ward round, orders could be fulfilled for patients who would be continuing treatment.


Condensing workload into an afternoon session allowed staff time to be freed up in the morning, enabling education and training of other staff within the aseptics unit and developing the team’s knowledge of the roles of other individuals who may have an interest in this area of pharmacy.


It also meant that staff were released to support other areas of the department in the mornings to ensure efficient working and supply of medicines to the wards during busy periods of the day/working week.


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