Service Redesign Care Home Services Paul Jerram Head of Medicines Management Isle of Wight CCG
The Health & Care of Older People in Care Homes July 2000 A comprehensive interdisciplinary approach A report of a joint working party Royal College of Physicians Royal College of Nursing British Geriatric Society
Causes of Concern Inappropriate usage of prescribed medication has been demonstrated in care homes. SEVERAL STUDIES HAVE SHOWN THAT 20-25% OF CARE HOME RESIDENTS RECEIVE AT LEAST ONE INAPPROPRIATE PRESCRIPTION Millard et al found that only 25% of GPs in nursing homes regularly reviewed the medication of each resident.
Recommendation To introduce a specialist pharmacist for homes (and medication review of the elderly and specific high risk populations)
Analysis of Authorised Repeats for Medication & Dressings Before Review
Project Following medication review, trained nurses, working to a protocol, can treat residents for minor conditions and use appropriate dressings without referral to a GP
Six Months Later Improvement in prescribing against a number of quality indicators Improved medication regime for residents Reduced workload for GPs, care home staff & pharmacists Reduction in cost of medication & dressings Empowerment of nurse clinical team Increased remuneration of pharmacists
Effect on Laxative usage
Effect on Medication & Dressing Costs
Service Redesign Brainstorm how we may improve existing services Select most appropriate updates Test concept and pilot Evaluate Roll out
Updates Patient passport Bar code patients Remote access to medical records E communication/records replaces paper Increased patient safety via Radar/scheduled and ad hoc monitoring Proteus ingestible sensors for compliance check in non care home patients Carer or patient self monitoring
Patient passport
Patient Passport
Viewing other results
Helius Project
Home Hypertension monitoring Project The Isle of Wight is already introducing the innovative Patient Passport , a service that allows the healthcare team access to the patients health records safely, securely and efficiently. It allows access to the ‘essential aspects’ of patients medical records: Clinical Conditions Medications & Allergies Blood Results & Investigations Health Plans