1. The Impact of EPMA on Day to Day Working for Clinical StaffBy
Jane Coleborn, Chief Pharmacist
Richard Musk, EPMA Pharmacist
Great Western Hospitals NHS Foundation Trust

2. Doctors What we thought Clinical decision support
aid less experienced staff
Mobile IT improved bedside care
What actually happens
Currently being over ridden without discussion with EPMA team
Lack of mobile devices for Dr’s, leading them not to review medication charts on rounds, systems too slow

3. Doctors (2) What we thought What actually happens Robust audit trail
Improved communication
Internal
External
Transcription error reduction
No re-writes
There but training required to pull/interpret information
Need an understanding of the system (int)
External - working but need to audit suitability of information
No transcription required
No re-writes required

4. Nurses What we thought What actually happens
Visual aide for when medicines are required
Electronic prescriptions always available
Status of order sent to pharmacy
Communication improved
Happens, however constraint by limited window of opportunity – 2hrs
Happens, but records can be locked, but not hidden
Happens, but delivery not specified
Happens, however no substitute for face to face contact

5. Nurses (2) What we thought What actually happens Legible prescriptions
Robust audit trail
Ordering named pt medication
Happens
There but training required to pull/interpret information
Safer and more efficient ordering process

6. Pharmacy What we thought What actually happens
Medication charts always available
Populating discharge letter
Instantaneous receipt of medication orders
Legible prescriptions
Robust audit trail
Happens, but records can be locked, but not hidden
Happens
Happens, but need to be clinically checked by pharmacy
Happens, safer system
There but training required to pull/interpret information

7. Pharmacy (2) What we thought What actually happens Audit KPI reporting
Paper light
Happens, but skill required in writing reports/extracting data
Happens, but as above
Supplementary chart still required, print out for transfer to non-EPMA wards, print out paper copy of TTA & I/P orders

8. Organisation What we thought What actually happens Better governance
Reduced risk
Data for service line reporting
Enhanced reputation for Trust
Happens but high lighting previous poor practices that can no longer be ignored
Happens but introduces own set
Trust is not able to utilise as other systems need to be in place
Potentially but………….

9. Patient What we thought What actually happens
Patient allergies recorded
Improved turn around times for TTA’s
Medication history stored centrally
Right medication, to right pt at right time
Happens but users still have to enter data first time round
Not currently obvious
Happens but increasing benefit over time
Not closed loop system e.g no pt positive identification functionality at present

10. Summary
We have been live since May 2015 – still embedding, some people love system and some don’t
Majority of EPMA benefits medium to long term
A lot of time still spent by pharmacy convincing trust and driving agenda, not optimising system
Prescribing was not perfect before EPMA but often overlooked – short memories

11. CQC visit Oct 2015 Raised as an issue during CQC visit
Transfer of information between paper based and electronic systems
Visibility of EPMA risk/issue log
Response to concerns
Training uptake