There is something reassuring and comforting about using paper charts in medication rounds. The paper charts are usually up-to-date, the Doctors updates to the medication regime are fairly legible most of the time, paper records never need rebooting, and it has been done this way for years.
Whilst this opening statement is somewhat tongue and cheek, it is reasonably safe to assume that the majority of Residential Aged Care Facilities in Australia still use paper based medication charts. This is hard to digest considering that electronic solutions are able to deliver quantifiable benefits to client safety and clinical workforce efficiency. Most clinicians are aware that medication errors are one of the biggest sources of preventable errors for most healthcare organisations. In a report by the Australian Institute of Health & Welfare, 30% of patients admitted from residential aged care facilities to hospitals were as admitted as a result of adverse medication events. Around 75% of these were preventable.
With so much promise of reducing medication incidents, why are more Residential Aged Care Facilities not making the shift to electronic medication management? Is it the cost, resistance to change, the complexity between the different parties (doctors, pharmacists, nurses), or is this 21st century initiative put into one of those baskets labelled “too hard”, or “next year”?
From my own experience as a Carer and RN in Residential Aged Care, I found it challenging to grasp how all the pieces fit together. The Aged Care Facility holds valuable information relating to patients and their care, whilst the pharmacy has valuable information about patients medication and dosing regimen. Throw the Doctor into the mix with medication changes and we have a melting pot of rich data from different sources, but a seemingly complex web of interrelated yet disparate information.
All is not lost. There are reputable companies out there that do this for a living. You don’t need to go down this journey alone. Remember, moving to electronic Medication Management (eMM) is essential to reducing medication errors, better compliance, time savings, cost savings and better drug safety. eMM IS a worthwhile initiative.
So, how do we push through the barriers and challenges to facilitate safer medication management practices for our patients/clients? How do we start the transition to eMM?
- Be open and prepared for change – Understanding the clear benefits of eMM and discussing it with others is the first step. Set realistic expectations. Keep reminding yourself of the end goal (improve medication outcomes for clients). System changes are only one aspect of the transition to eMM. Processes will also be impacted, and it will take a little time to adjust and work through the teething problems.
- Plan and communicate – Set clear objectives and plan for the change. Understand the impacts, and communicate your planned changes to clients, colleagues and any person/entity that is potentially affected by the change. Reiterate the benefits.
- Close the loop – eMM systems that are not connected (ie, pharmacy and aged care systems) hold much less promise of reducing medication errors. If an Aged Care eMM system is not sourcing the drug/dosing data direct from the pharmacy system, then there is significant risks of data entry duplication, transcription errors, contraindication errors, etc. Having connected systems saves time, eliminates duplication, minimises dosing errors, and increases efficiencies and communication between Pharmacy and Aged Care.
- Plan for implementation – Discuss implementation and planning with your software provider(s). They should have the expertise to properly plan for your transition to eMM.
It may only be a matter of time before the accreditation standards and compliance requirements force Aged Care Providers down the road of eMM. And it makes sense too, as hand-written medication charts need to be a thing of the past (illegible hand writing dramatically increases the chance of medications being wrongly prescribed, dispensed and administered). With the ability to streamline medication administration, improve communication with pharmacies, and integrate the clinical and medication information, now is a good a time as any to make the shift to eMM.
Good luck.
Ben Ward 