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How our trust tackled medicines wastage by 70%

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9 April 2018

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University Hospitals of Leicester (UHL) NHS Trust saw an opportunity to use robotics to revolutionise drug dispensing and reduce medicines wastage by 71%.

 

The problem

 

In 2015/16, NHS England spent over £7bn on medicines for hospitals.

 

When it comes to medicine use, sometimes mistakes are made at the prescribing stage, when the doctor takes decisions on the therapeutic part.

 

University Hospitals of Leicester (UHL) NHS Trust saw an opportunity to use robotics to revolutionise drug dispensing and reduce medicines wastage by 71%.

 

The problem

 

In 2015/16, NHS England spent over £7bn on medicines for hospitals.

 

When it comes to medicine use, sometimes mistakes are made at the prescribing stage, when the doctor takes decisions on the therapeutic part.

 

Then ­– and this is probably a larger proportion of errors – errors occur at the execution process. That’s predominantly when nurses read the prescription, select the medications and give them to the patients.

 

Medicines errors are one of the major causes of serious patient safety events.

 

UHL is a large teaching hospital, with around 1,800 beds and the busiest emergency department and floors in England. These two combinations presents the pharmacy service with challenges to make sure we get medicines to the right patient at the right time.

 

We had high level of missed doses, because the nurse couldn’t find the medicines, which ran somewhere between 8 and 10% at the costs of the NHS.

 

The solution

 

Innovations that can improve the process of hospital medicines management deliver significant financial, operational and clinical benefits.

 

Our optimisation of medicines delivery using individualised doses (OptiMed-ID) project uses a robotic machine – imported from Italy – to support the supply, storage and administration of in-patient medication.

 

If the doctor prescribes on electronic charts, it’s immediately much more clear what they intend to give.

 

Instead of supplying packs of medications, we supply drugs to the ward in individual unit doses, such as tablets, ampoules, pre-filled syringe and such things.

 

The system reduces wastage and errors by using barcode technology to identify patients and the drugs the nurses give them, which is tied to electronic prescriptions, so we know that prescriptions are the right ones for the right patients and that medications the same as the ones that have been prescribed.

 

The result

 

After deploying OptiMed-ID throughout four wards, we saw:

 

·       A 25% reduction in the consumption and costs of medicines

 

·       A 55% reduction in the number of items held in the ward stock cupboards

 

·       A 71% reduction in the value of medicines wastage

 

·       A reduction in missed doses from 10% to 1.2%

 

·       Six full time jobs created by Ingegneria Biomedica Santa Lucia IBSL (UK) Ltd – an Italian company that provides clinical engineering services and biomedical equipment services

 

Every time nurses scan a drug before giving them to patients, the logistical software that’s running the background knows what has been taken out the cupboard and used. It then starts to produce a replenishment list for the stock cupboard.

 

We found that the supply of medications was much more accurately controlled and the flows were based on actual usage rather than on what people could find in the cupboards.

 

There was a reduction in the time it was taking nurses to find medications.

 

It also reduced the number of medication returns to pharmacy, which aren’t needed anymore, as in the acute setting patients who are stabilised have their medicines changed on a regular basis either because the bodies’ response haven’t been as good as we hoped or patients had a reaction to the drug.

 

We supply drugs for patients who are sitting in the wards but also for patients to take home with. We saw that the number of drugs that were supplied to in-ward patients fell significantly, over 50%.

 

The future

 

East Midlands Academic Health Science Network (EMAHSN) is supporting the expansion of OptiMed-ID within six additional wards at the trust, along with the preparations for a trust-wide rollout.

 

There is an opportunity for hospitals in this country to have medications delivered to a unit dose laboratory facility and shipped against what’s needed for the cabinets on the wards. We’re developing plans for such a hub and spoke model to ensure cost effective widespread deployment.

 

We’ll continue to host open day visits for trusts and VIP, such as Keith Ridge, to support wider adoption and spread throughout the country.

 

Trust comment

 

‘Saving money in the NHS is extremely important.

 

‘I think there is general interest around this model. We’ve hosted a few open days and a number of trusts were very interested in what we’ve been able to achieve, both from a patient safety and a financial savings perspective.

 

‘We are confident that this system could be a future model to improve medicines management and reduce waste across the NHS.’

 

Graeme Hall is the associate chief pharmacist and chief pharmacy information officer at University Hospitals of Leicester NHS Trust

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