1. Introducing ePMA into a Paediatric ITU Will Hall - Lead Pharmacist for ePMA

2. Objectives Introduction to the St Georges EPR project Brief explanation of the challenges of paper on PICU Change management strategies Lesson’s Learnt – What would we do differently?

3. ItemMetric Number of core facilities3 Number of beds1,000 Full Time Equivalent7,173 Total Headcount7,700 Number of IP admissions /year107,976 Number of IP Daycases / year26,925 Number of OP attendances / year683,490 Number of ED attendances / year163,810 Number of operating theatres29 Number of births /year5,118 Number of critical care beds90

4. ‘The error of one moment becomes the sorrow of whole life.’ A Chinese Proverb

5. Medicines safety is a key concern Errors do occur, UK studies show that: o Prescribing errors occur in 1.5 - 9.2% of medication orders written for hospital inpatients o Dispensing errors are identified in 0.02% of dispensed items o Medication administration errors occur in 3.0 - 8.0% of non- intravenous doses and about 50% of all intravenous doses The use of ePrescribing can help reduce such errors Source: Vincent C, Barber N, Franklin BD, Burnett S.The contribution of pharmacy to making Britain a safer place to take medicines. Royal Pharmaceutical Society of Great Britain: London; 2009.

6. Our Quest towards Comprehensive Medication Safety

7. Medication Safety: Long term global vision To perfect the medication delivery system to be safe for every patient, every time, while making it easy for caregivers to do the right thing, and impossible to do the wrong thing.

8. Comprehensive Medication Safety 1990 Pharmacy Information System 2007 CPOE Chemotherapy (Prescribing and Admin) 2009-11Smart Infusion Technology Hospital Wide 2010 Cerner PAS 2010Robotic Medication Dispensing in Pharmacy 2012 Cerner CPOE (Radiology & Laboratory) 06/2014 Cerner ePMA & Clinical Docs 06/2014Cerner Care Administration

9. Initial Aim’s and Scope of ePMA Eliminate End of bed charting combining vital monitoring and medication rates Provide Safety in Medication Administration process with Barcode Medication Administration Eliminate additional charts associated with medication trust wide Convert all prescription’s to an electronic system Eliminate Medication Charts Trust Wide Adult ICU Paed ICU Patient Drug, Dose, Time Epidural Warfarin Inpatient Discharge Outpatient Complete CPOE

11. Specific Challenges in PICU

13. PICU Project 3 Month project Supplement to Enterprise Wide Solution 2 Nursing Leads, 1 Consultant Lead

16. Ready for go-live?

17. Superusers

18. Champion users

19. Pocket Guides

21. Deployment Access to ePMA staff (epma@stgeorges.nhs.uk)epma@stgeorges.nhs.uk Listen, Action, Listen, Action Ward handover Audit Redesign Safety comes first

22. Lesson’s Learnt Scope 2 Integration Leadership is key Education and Training Task Group Clinical Champion’s and Super users

23. Integration

25. This enables improvements to clinical care