Safe Medication Management Programme > Clinicians

Clinicians

The Safe Medication Management Programme (SMM) will look at the processes undertaken in prescribing, dispensing, administering and reviewing medications for patients/consumers and the information available to clinicians to support these processes.

The programme will then work with the health and disability sector to develop an electronic system (e-prescribing) for medication information transfer and decision support for clinicians. E-prescribing will result in improvements to medication management across the health and disability sector and improve patient safety by reducing adverse drug events.

While the programme will initially focus on hospitals and their interface with primary care, it will also develop systems to allow the programme to extend across the entire sector.

How do adverse drug events occur?

Potential adverse drug events can occur throughout the health and disability sector at any time when medications are prescribed, dispensed or administered to a patient/consumer.

People are most at risk from adverse drug events at any time when information about that person is transferred from one part of the health and disability sector to another or at any time information is passed within a primary or secondary health care setting.

For example, adverse drug events can occur when:

In a primary setting a general practitioner issues a prescription, which is taken by the patient to the pharmacy where it is then entered manually in the pharmacy's system.

In a secondary setting when a clinician prescribes medication to a patient and the prescription is hand written on a medication chart.

Patients may be harmed when:

The wrong medication is given to a person
The wrong dose is given to a person
The medication is administered to a person who is known to be allergic to that medication
The medication is administered incorrectly or using the wrong route (i.e. orally instead of by injection)
The medication is administered at the wrong time or doses are missed

Currently there are a number of systems, both electronic and manual, across the health and disability sector, all of which have the goal of ensuring the right drug at the right dose is administered to the right patient/consumer, by the right route and at the right time.

Staff involved in every part of the medication process work hard to ensure patients are safe and well looked after while they are in their care. But sometimes errors can and do occur.

The Safe Medication Management Programme (SMM) has been put in place to help clinicians reduce these events and the ensuing impact on patients/consumers.

For the SMM Programme to be successful we need the support of the entire health and disability sector including governance, management, clinicians and IT staff.

If you would like to be actively engaged in the programme please contact us.

The Work Streams

A number of outcomes have been identified as necessary to reduce patient/consumer harm through adverse drug events. Multi-disciplinary Working Groups, with members from across the 21 DHBs, have been put together to develop processes, which will deliver these outcomes.

The Working Groups are developing standards and processes for:

Medication Chart / E-prescribing

Medication charting standards will ensure consistency for prescribing and administering medications and will form the basis for e-prescribing.

E-prescribing will provide clinicians with decision support for prescribing and reviewing medications. It will do this by providing choices of medication, doses, timing and possible interactions and will then record the decisions made.

The system may also link with diagnostic results, which would assist clinicians to make decisions about what medication to prescribe.

Standardise and Link Systems

Standardised hospital medicine information systems will provide support and ensure consistency with e-prescribing, bedside verification and medicine reconciliation.

The system will be linked to bring together all the information from the medication systems to ensure there is consistent messaging for prescribing, dispensing, administering and reviewing of medications for patients/consumers.

The system will have the capability to link to community systems.

Unit Dose / Bedside Verification

Unit dose packaging and electronically identifying medications (for instance by bar coding) will provide a safer way to ensure that patients receive the prescribed medication at the prescribed dose.

Bedside verification will electronically identify the intended administrator of the medication, the medication itself and the patient.

Medicine Reconciliation

Medicine reconciliation (MR) is an evidence-based process which has been demonstrated to significantly reduce medication errors that occur at transition points of care (admission, transfer and discharge).

The goal for medicine reconciliation is to complete the MR process for all patients at each transition point (within 24 hours of admission and transfer and at discharge) within and from secondary care. Therefore achieving a sustained reduction in discrepancies that have the potential to become medication errors or result in medication related harm to the patient.

CLINICIANS