1. 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

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

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

4. EDC

5. EDC Prescription

6. 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

7. 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

8. 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

9. Exclusions
Hospital transfers
Bone marrow transplant
HIV
Oncology

10. Results

11. Results

12. 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

13. 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

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