Transcript Bridging the Gap collaborating to spread improvement

Bridging the Gap
collaborating to spread improvement
National Medicines Management
Programme & All Wales Chief
Pharmacists
Sept 7th 2012
All Nations Centre, Cardiff
Andrew Cottom CEO Powys LHB
Chair – National Medicines Management Programme
• Year 1 – Foundations
The Answer is in the Room
Top 14 measures
Prescribing Dashboard & Accelerator
National Formulary System & MTED
Links with AWMSG
• Year 2 – Building Blocks
Restrain the escalation of the drug spend
Reduce unit cost
Reduce volume
Increase will
• Year 3 – Operational
Spread with interventions and SBARs
Planning & measurement
Whole System Thinking
Electronics & Technology
1. ACE inhibitors
2. Statins
3. Erythropoietins
4. Neuroleptic agents
5. Antidepressants, anxiolytics
and hypnotics
6. Review NSAID prescribing
7. Proton Pump Inhibitors (PPIs)
8. Respiratory
9. Non-drug products.
10. Special Products
11.Antibiotics
12.Medicines of limited value
(e.g. glucosamine)
13.Poly-pharmacy
14.Antiplatelet agents
Anne Bithell
Chair – Welsh Chief Pharmacists Committee
Chief of Staff Pharmacy & Medicines Management CPG BCUHB
Aim of the day
Develop plans to increase the will and
capacity to spread improvement
Progress to date
• Year 1 – Foundations
The Answer is in the Room
Top 14 measures
Prescribing Dashboard & Accelerator
National Formulary System & MTED
Links with AWMSG
• Year 2 – Building Blocks
Restrain the escalation of the drug spend
Reduce unit cost
Reduce volume
Increase will
• Year 3 – Operational
Spread with interventions and SBARs
Planning & measurement
Whole System Thinking
Electronics & Technology
1. ACE inhibitors
2. Statins
3. Erythropoietins
4. Neuroleptic agents
5. Antidepressants, anxiolytics
and hypnotics
6. Review NSAID prescribing
7. Proton Pump Inhibitors (PPIs)
8. Respiratory
9. Non-drug products.
10. Special Products
11.Antibiotics
12.Medicines of limited value
(e.g. glucosamine)
13.Poly-pharmacy
14.Antiplatelet agents
Learning & Spreading
• Morning session – each LHB to share learning
from a project
• Afternoon session – how do we plan,
influence and spread
Programme (morning)
09:30
(Part1)
10:00
Registration/Network/Refreshments
10.15
The journey to sustainable and widespread improvement – medicines
matter.
Professor Dyfrig Hughes
10.45
Medicines Matter – Movement & Improvements Market
Health Boards improvement tables
12.00
People of influence from the patient to the professional – medicines
Jamie Hayes
Welcome, introduction & today’s purpose
12.30
(part 1 close)
Co Chairs
Key learning and messages
Co Chairs
matter
Programme (afternoon)
12:45 – 1.30
(Part 2)
1.30
1.40
3.00
Network & LUNCH
Introduction and scene setting
Co Chairs
Using influence to effectively spread improved practice –
Steve J Martin Master class
BREAK
3.15
Using influence to effectively spread improved practice –
Steve J Martin Master class
3.55
Leading messages, thanks and close.
Co Chairs
How can we influence and spread our
interventions?
Who to Influence?
• Strategic level
• Operational level
• Patients and service users
How to Influence?
• Education and training
• Incentives
• Publications and newsletters
• Etc.
Example Intervention at BCUHB
Stopping the drug (Poly-pharmacy)
Aim: To reduce levels of poly-pharmacy by 5% in 6 months
Measure: “The % of patients over 65 with 15 or more items*
on their repeat slip” (*this may include dressings etc)
Intervention:
Review 20 patients as a learning tool.
Example run chart and possible
interventions
Partners meeting;
GP champion
found
Do “clean up search”
Link in with
MURs
Review 20
patients
The test practice
had 1,800 patients
over 65; 58 with
over 15 items
Med review
added to LES
2012-13
Peer review &
education
session
Get specialist
help from hospital
Think again?
What are other
practices like?
21/07/2015
13
What are the gaps to bridge?
•
•
•
•
•
Financial
Professional
Structural
Cultural
Innovation & Technological
Aim
Primary Drivers
Ordering
Prescribing
Reduce Medicines Waste
Usage
Awareness
Secondary Drivers
Interventions
Patient orders from surgery
Patient orders from pharmacy
Pharmacy managed repeats
Care Homes
Synchronisation; on line ordering,
repeat slip
Repeat dispensing
Monitor waste
Care Home policies/training
Care Homes
Adverse effects
Dosage form (inability to
swallow, use device etc)
Acute illness
Hospital discharge
National Guidance/Guidelines
Formulary
Patient Demand
Bulk ordering, MDS, Dressings
supplies
28 day prescribing, medication
review
Specials, inhaler technique training
Quantities e. g. analgesics, NSAIDs
Medicines reconciliation on
discharge
1000 Lives /LES
Targeted discharge MUR
ScriptSwitch
Formulary compliance reporting;
LES
No on demand prescribing of OTC
medicines
Medicines adherence
Carer skills & knowledge
Concordance
Targeted MURs , inhaler technique,
Carer support, training & advice
MURs
Health professionals
Publicity (TV, radio campaigns)
Advertising (leaflets, back of buses)
Patient education (antibiotics etc)
What are we trying to achieve?