Penny Fletcher MSc MRPharmS IPresc Audit and re-audit of documentation of changes to medicines on discharge letters in paediatrics at St Mary’s Hospital Penny Fletcher MSc MRPharmS IPresc Senior lead pharmacist Women and Children Project supervisor Data collected by E L Alford, Pharmacy student, 2010 S Mesgarpour Pre-registration pharmacist, 2011

Background Primary care audits have suggested poor communication from hospital to GP In particular low levels of information of new and changes to medicines

Objectives Measure communication of changes to medicines Evaluate effect of “EDCv2” Electronic discharge summary (discharge prescription / GP letter)

EDC

EDC Prescription

Standard CQUIN 60% initially in 2010 80% by end March 2011 Commissioning for Quality and Innovation 60% initially in 2010 Reasons for new / changes to medicines documented 80% by end March 2011 Financial incentive

Methods Prospective data collection over 2 weeks (including weekends) May 2010 Data presented to paediatric team EDCv2 implemented August 2010 Repeat data collection over 2 weeks January 2011

Methods Discharged patients identified from handover sheets each day Drug charts and medical notes reviewed Identify new medicines & changes Review EDC for documentation of changes Completed a data collection form QA by senior pharmacist

Exclusions Hospital transfers Bone marrow transplant HIV Oncology

Results

Results

Discussion Initial audit had a significant effect to raise profile of the need to complete EDCs “Other” discharge letters also found Culture change to use EDC Automatic “initiation” as EDCv2 linked to ICHIS Teaching at doctor induction re EDCv2 And need to document changes

Conclusions Prior to EDC v2 CQUIN target not met There was a significant increase in the number of children getting an EDC with version 2 Further work needs to be done to achieve the target of 80% documentation of changes to medicines Including role of pharmacist Consider a mandatory indication field

Any questions? Acknowledgements: Data collected by: Liz Alford, Pharmacy student, USA, 2010 Sahar Mesgarpour Pre-registration pharmacist, 2011