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AWARDS


HOSPITAL PHARMACY TEAM OF YEAR


supported by


COMBINED ASSESSMENT PHARMACY TEAM, UNIVERSITY HOSPITAL, CROSSHOUSE AND UNIVERSITY HOSPITAL, AYR


Following the establishment of the Combined Assessment Unit (CAU) at the University Hospital Crosshouse (UHC) in April 2016 and at University Hospital, Ayr (UHA) in 2017, funding was obtained for a designated pharmacy team specialising in unscheduled care.


The CAU pharmacy teams are dynamic and motivated teams, who are fully integrated into the wider hospital multi-disciplinary teams. The teams have adapted - and continue to adapt - to cope with both high workload demand and the unpredictable nature of unscheduled care, with a particular focus on providing optimal patient care and supporting flow throughout both the unit and hospital sites


Both teams are viewed by both sites as integral to the provision of high- quality patient care, ensuring safe, optimal use of medicines, supporting and taking on the role of prescribing of medicines within the units and playing a crucial role in ensuring patient flow through reducing time taken to discharge.


The team’s objectives were clear:


• Achieving government and health board targets on medicines reconciliation, venous thromboembolism (VTE) prophylaxis and antimicrobial stewardship


• Meeting service demands through extended opening hours, developing new ways of working and extending the roles of the pharmacy team


• Improving patient flow by early identification of patient discharges, improved prescription turnaround


times and working collaboratively with the multi-disciplinary team through development of improved prescribing and communication methods using IT systems


• Reducing medicines wastage and cost-effective prescribing through introduction of new drug ordering system, regular review of ward and dispensary stock lists and audit of drug use and


The senior/specialist pharmacists involved in the team have considerable experience in acute medical and surgical areas – particularly in the areas of cardiology and respiratory - as these account for a large proportion of the admissions.


As a result of the collaborative working, a pharmacist is now present on all morning ward rounds and this ensures that the targets for medicines reconciliation, VTE prophylaxis and antimicrobial stewardship are highlighted and addressed for each patient. In addition, the pharmacy- related care issues are dealt with when patient treatment plans are being decided. As a result, this method of working has not only improved relationships with the multi-disciplinary team, but has also increased the profile of the clinical pharmacy team’s role on the ward.


The combination of working in clinical practice and awareness of the HEPMA system and its potential has allowed the pharmacy team to improve prescribing communication and patient flow. The collaboration of the HEPMA system with the eWhiteboard has made a significant improvement


To view Scottish Pharmacist Awards Highlights visit www.scottishpharmacist.co.uk/awards


Combined Assessment Unit Pharmacy Team, University Hospital Crosshouse and University Hospital Ayr celebrate with Stuart Lucas, Managing Director, PSUK (A Phoenix Company)


to pharmacy discharge turnaround times and work load planning. The development of a handover tool within the HEPMA system has highlighted patients on high-risk medicines, time since admission, time since last review and has facilitated discharge planning.


The time taken for the medicine reconciliation process has been shortened by the collaborative working of pharmacists and technicians where the technicians carry out the initial drug history, allowing the pharmacist to concentrate on individual pharmaceutical care issues on the ward round.


The introduction of the eWhiteboard has enabled the team to prioritise workload off the ward round effectively by identifying patients with bed allocations and those approaching 24 hours since admission. The introduction of these new ways of working has increased medicines reconciliation numbers from an average on one site of 509 patients/ month (January – March 2017) to 722 patients/month (September – November 2017).


Another analysis over two full weeks on one site highlighted that the


team was reviewing medicines for 62 per cent of patients admitted to CAU and that, of these patients, 87 per cent were seen within 24 hours. This is one of the key performance indicators identified by the National Acute Pharmacists Group to facilitate benchmarking of the clinical service performance.


Another example of collaborative working is the participation in the CAU 12 noon huddle with other disciplines which has provided a new way of information exchange and input into the patient journey. A subsequent pharmacy ‘debrief’ then allows the opportunity to systematically outline and review care issues, discharge status and feedback from the ward before reallocation of work load for the afternoon.


All acute hospital sites face increasing challenges on a daily basis, but this capable, motivated, flexible and ever- evolving pharmacy team has more than stepped up to these challenges.


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