Pharmacy Case Study – Improving Patient Information and Involvement
Central Manchester Foundation Trust consists of six specialist hospitals where we treat more than one million patients every year. Patients have a wide range of medical and surgical needs and come from diverse ethnic and cultural backgrounds.
Empowered and informed patients can take responsibility for their medicines choices. This project aims to encourage medicines adherence and prevent re-admission due to inappropriate or inadvertent use of medicines. The patient and their direct need for information are key within this project. Subsequent tackling of the CQUIN targets relating to patient experience is an added bonus.
The results from the National In-patient Survey highlighted that patients perceive they are not fully informed about their medicines, including information relating to side-effects. It was clear that we needed to alter the method by which we provided this information about medicines as patients, when surveyed, obviously perceived that we were not providing sufficient drug-related advice.
Within the Medicines Information (MI) Department, a Pharmacy Medicines Helpline is provided for patients who are discharged with medicines. We aim to capture patients who have additional queries or seek additional advice relating to their discharge medicines when they get home. A large proportion of the calls we receive from patients are related to adverse effects. The MI Dept was therefore identified as having an important role in the reactive provision of information.
In an attempt to improve our proactive provision of information relating to medicines within our Trust, a multidisciplinary approach was deemed necessary. The MI manager and Lead Nursing staff began a project to improve patient perception on the provision of medicines information.
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The provision of medicines information to patients is now a focus for all healthcare professionals. There are already specialist pharmacists developing patient counselling tools for their specific clinical areas. Training and counselling competency packs have been developed for key areas where departmental audit has highlighted a deficient area in patient counselling. Education of patients is an important strategy in effective medicines optimisation.
This is a unique project which involved a multi-disciplinary approach to proactive provision of medicines information. The project was developed with the QIPP agenda at its forefront. We aim to ensure the patient receives quality information in an appropriate way, using techniques which have not been employed elsewhere, advancing collaborative working among the MDT, to prevent harm to the patient through inappropriate use of medicines on non-adherence to prescribed regimes.
Key Learning
The roll out of this project in a Trust this size has had it difficulties. Engaging large numbers of staff across multiple sites has logistically been problematic. It is advisable in the early stages of the project to ensure you have all relevant parties on board. The project became not only about providing information proactively to patients; the tools with which to do this have become integral to ensuring good discharge practice, alongside medicines safety and governance. Anticipation of how the tools can be adapted to other UK Trusts should account for any local needs in these areas in advance as this may speed up the process of eventual implementation.
Tools which have the potential to be shared and adapted for other Trusts included a Pharmacy Admissions Leaflet which explains to the patient more about medicines during their hospital stay, and the Core Discharge Checklist. This is a simple ten point checklist which covers the key pieces of information which need to be provided to a patient to ensure patients are safely discharge with medicines. There are accompanying educational packages associated with this Checklist.