Reducing length of stay through medicines management interventions

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Reducing length of stay through medicines
management interventions

• Key Slides

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What is medicines management?

• Medicines management encompasses the entire way
  that medicines are selected, procured, delivered,
  prescribed, administered and reviewed to optimise
  the contribution that medicines make to producing
  desired outcomes of patients care.

A Spoonful of sugar. Medicines management in NHS
Hospitals. The Audit Commission (2001)
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Why is reducing length of stay important?

• Patient
• Increased morbidity
• Loss of autonomy
• Increased costs to patient and visitors
• Higher risk of hospital acquired infection
• Higher risk of adverse drug reaction

• NHS
• Additional use of NHS resources
• Greater risk of adverse events
• Adverse publicity
• Increased financial cost to Trust
• Payment by Results
• Bed occupancy

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Maximising technical services

• Stock management Formulary enforcement
• Electronic prescribing/ordering
• Automation in dispensary, at ward level
• Satellite pharmacies
• Correct dispensary skill mix
• Use of patients own drugs (PODs)
• Dispensing for discharge
• Pre-packaged medicines for discharge
• Weekend working/ 24 hour pharmacy
• Motivation of staff

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Clinical Interventions

• Assertiveness
• Medication history taking
• Policy development and implementation
• Prescribing and prescribing advice
• Surgical interventions
• Ward round participation
• Palliative care interventions
• Interface liaison

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Reducing Harm

• Adverse Drug Reactions (ADRs), Adverse Drug
  Events (ADEs) and Hospital-Acquired Infections
  (HAIs) can increase patient length of stay
• ADRs are preventable in 50-70 of cases
• ADEs are generally preventable through
  appropriate development and implementation of
  procedures
• Pharmacists have a key role to play in reducing
  the incidence of hospital-acquired infection