Authors (including presenting author) :
Cheung DST, Lai EOL, Tsoi HHY, Ho VKW, Wong HSY, Ip ATK, Tse HHK, Yeung DKY, Wong AHY, Lau APW, Wong VKC, Cheung TYH, Chan TCC, Ng CCH, Kong HS, Wong CFF, Chui WCM
Affiliation :
Department of Pharmacy, Queen Mary Hospital
Introduction :
Upon implementation of Inpatient Medication Order Entry (IPMOE) in Queen Mary Hospital, quite a substantial increase in number of dispensing items and ward return is observed in Pharmacy. One of the main reasons is due to the supply of refill medications to patients who are pending to be discharged shortly, especially in wards with high turnover rate like Medical Admission Wards. Measures are needed to reduce unnecessary medication supply to wards, in order to increase the safety and efficiency of the drug distribution process, and reducing drug wastage and workload of both Pharmacy and Nursing staff.
Objectives :
To evaluate the impact of "Pending Discharge" function in IPMOE on reducing unnecessary medication supply to Medical Admission Wards.
Methodology :
In IPMOE, patient status can be changed from "Active" to "Pending Discharge", after the change, the supply of refill medications to patients can be stopped. With the support of Clinical Pharmacists and Nurses in Medical Admission wards, the workflow of using the "Pending Discharge" function is established. Ward staff in Medical Admission wards fax a Pending Discharge List to Inpatient Pharmacy before 1pm on weekdays. Inpatient Pharmacy staff then change the patient status as "Pending discharge" in the IPMOE profile by 2pm. This can stop the automatic drug refill from Pharmacy in the afternoon and reduce unnecessary medication supply to wards.
Result & Outcome :
From September to November 2018, the average number of patients pending to be discharged per day by 2pm in the six Medical Admission Wards was 22.4 (3.7 per ward). The average number of refill items saved from dispensing per day was 18.8 (SD 9.8), with 14.6 non-injection and 4.2 injection items. The average percentage of afternoon refill items saved from dispensing per day was 9.58% (SD 5.01%). It was demonstrated that usage of the "Pending Discharge" function in IPMOE could reduce unnecessary medication supply to wards by nearly 10%, which could enhance the safety and efficiency of drug management, and reduce drug wastage and workload of both Pharmacy and Nursing staff.
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