The Royal Cornwall Hospitals NHS Trust is the principal provider of acute care services in Cornwall. The Trust is continually developing its clinical services to keep at the forefront of medical technology and is committed to maximising the range of specialist care that can be offered locally.
What was the experience of implementing CMM’s EPMA like?
The deployment of CMM’s EPMA took about 12 months of hard work but had a rewarding outcome that was positively received by staff.
The first six months were essentially a pilot period where the staff got to know the system inside out, the ensuing six months focused on deploying the system across the Trust.
We ended up going live across all 14 wards and theatres in surgery in one day as we realised that speed is of the essence in a mixed economy to avoid patient risk.
What benefits has CMM’s EPMA brought to the Trust?
As a prescribing tool and an administration tool, CMM is fantastic, but the real power of it comes from the data that it generates.
“The data is really helping us to target our specialist knowledge and our expertise to an individual patient level.”
lain Davidson, Chief Pharmacist and CCIO
The Trust has developed different web tools using the data, for example, an antibiotic web page that shows all the antibiotics that are prescribed in the hospital.
We’ve also developed a risk profile tool called the ‘Pharmacist’s Friend’ that shows pharmacists which patients have had their medicine reconciliation done, who’s on a high-risk antibiotic, and who has missed doses of critical medicines in the last 24 hours as soon as they go onto the ward.
As a result, pharmacists can now make sure that they’re going to the highest risk patients first rather than just working their way around the ward.
Tools have also been developed for specialist nurses – the ‘Thrombosis Friend’ and the ‘Parkinson’s Nurse Friend’ – which are specialist web pages that display which patients are relevant to their work, where exactly they are in the ward and whether they’ve missed any doses of their medicines.
How is the Trust using CMM EPMA data to improve antibiotic use and antibiotic stewardship?
Electronic prescribing has allowed the Trust to give special attention to our antibiotic stewardship. We’re now able to pick up those prescribers that aren’t adhering to guidelines and offer them additional support and training to make sure they understand the importance of good stewardship.
From this approach, the Trust has seen a reduction in Clostridium difficile rates, and we’re seeing a much higher profile of antibiotic stewardship within the Trust because we can report incredibly robust data right up to the exec level.
How is the Trust using CMM EPMA data to reduce missed doses?
The data generated by CMM is helping us to reduce the amount of missed doses in the Trust because we now know exactly what the missed dose rate is and the reason why.
For example, at four o’clock every morning an email goes to the ward sister of any dose of a critical medicine within the last 24 hours that’s been missed on that ward. That info is then taken to the morning handover so they can address the issue.
The Trust has also introduced automatic electronic ordering for ward-stock, so instead of walking paper orders down from the ward, the nurse just ticks a box to say that they need a further supply of a certain medicine.
“Electronic ordering and monitoring has transformed the workload in the pharmacy; we used to get about 20% of our work done before 11 o’clock in the morning, now we’re getting over 40% done by the same time.”
lain Davidson, Chief Pharmacist and CCIO
How did you find working alongside WellSky as a partner?
The Trust has worked with CMM for a number of years and it’s been amazing how quickly CMM have been able to adapt the system to make it more user-friendly.
Looking at CMM’s roadmap ahead and the fact that CMM has such a big footprint in the UK, we think there’s going to be some really good changes bringing in amendments and enhancements that Trusts have been asking for that will improve usability even more.
Is the Trust planning to share its experiences across the NHS to support best-practice?
The team at the Trust have become experts in the deployment of electronic prescribing and we are keen to share our experience across the NHS as other Trusts adopt electronic prescribing.
They hope to work with other Trusts’ project teams to help them design, setup and progress through their deployment to make sure they have as successful a deployment as we have