Automation solutions essential for reducing administration errors
Ed Platt, Automation and Analytics Director at Omnicell International, describes a step-by-step process for implementing automation technologies across NHS.
There are enough tried and tested technology solutions today to all but eradicate prescription and administration errors from across the healthcare system. It is therefore all the more concerning that 6,000 people were harmed and 29 died last year in England following prescription errors.
Data from NHS England, via the National Reporting and Learning System (NRLS), reveals that almost one in six Trusts in England do not even have a funded plan in place to reduce these errors via electronic prescribing systems – an issue raised in the media recently by Peter Walsh, Chief Executive of Action against Medical Accidents.
It seems baffling that not all Trusts have a suitable plan for adoption of electronic prescribing – why is the adoption of digital technology and more specifically, automation solutions, not front of mind? The UK’s Prime Minister, Rishi Sunak, echoed this message at the recent Confederation of British Industry (CBI) conference in Birmingham, when he called for more investment in automation and technological innovation as part of NHS reforms.
For any Trust at the moment, there is a lot of ‘fire-fighting’ taking place in terms of resources. In the aftermath of Covid, Trusts have had to be focused on a ‘recovery’ strategy, with the added burden of staff retention and recruitment issues. These are, understandably, posing extreme funding challenges and the job of leadership teams is not to be envied.
With a need to justify investment at such a testing time in the sector, many are finding it hard to put a number on the cost of such errors. According to studies, one in ten doses are not given to patients. However, many errors are also under-reported, so hypothesising a number to make a clear-cut case for investment in automation is almost impossible. It is simply not possible to monetise the impact of medication errors to show the economic effect. It is no wonder, therefore, that many Trusts are finding it hard to commit to a plan, despite having an intuitive feeling that they should invest in this area.
I know from personal experience the challenges nursing and pharmacy staff within hospitals are faced with when it comes to medication management; one hospital I visited recently required nurses to locate patient medication from 17 different locations across the ward with the patient and his/her needs at the very core of their service. This is simply not sustainable and makes the risk of mistakes undoubtedly higher. But broad-based challenges such as this, which are difficult to measure, are always going to be secondary for Trusts when compared with the most pressing and immediate concerns.
The ‘gold standard’ for any hospital should be electronic prescribing with automation. These two go hand-in-hand to ensure: improved patient safety; fewer medication errors; fewer missed doses; fewer drugs wasted; fewer instances of out-of-stock medicines, and reduced clinical staff time spent preparing and dispensing medication.
The impact of automation can swiftly be felt across an organisation, especially when key issues such as staff morale are considered. Automation takes the headache out of mundane and repetitive tasks, meaning clinical staff can concentrate on patient care, with a reduced workload and can do what they joined the NHS to do. The process should place patients at the heart of the service, to understand their medicine requirements and feel empowered. importantly, it will also facilitate the faster discharge of patients, either back home or into a community-based care setting, whilst eliminating avoidable waste in the system.
For successful investment and implementation of automation in any NHS Trust, I would recommend the following 7-step process to ensure success:
Ø Assess and understand your organisation’s current challenges – consider the hospital’s geography, ward layout, supply chain from central pharmacy to wards, discharge processes, workflows, date quality and current and future digital systems.
Ø Integration with existing digital systems – can it integrate seamlessly with existing solutions – both electronic prescribing systems and electronic patient record systems? The ability to integrate will help optimise both workflow and data visibility.
Ø Change management – The successful adoption of technology includes the need to have a solid change management plan in place. Immediate employee engagement is key for bringing about change in the workplace – employees have to be part of the planning as much as the execution. Ensure pharmacy, nursing teams and digital leaders work together to put a holistic solution in place.
Ø Training – Ensure there is a clear training plan, clear SOPs, roles and responsibilities, and an ongoing training strategy to maintain standards.
Ø Adoption – It is essential to work with the right partners. Technology solution providers need to spend time on site understanding different workflows in various departments and provide expert guidance on how technology can best be used to make significant time and cost savings very quickly. This should be scalable from a ward, to a hospital, Trust and ICS so that consistent standards and workflows can be adopted.
Ø Execution – A go-live with the correct resource, clear clarity of the future state, at the shoulder support and swift resolution to any challenges.
Ø Life-support and follow-up – Experts should be on-hand to provide guidance and communication materials, and tailor, where possible, the technology to suit the specific case required by the hospital. Clear metrics and measurements to determine the expected outcomes ought to be in place.