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Transcript facilitator-introduction

Improving Analgesia in
Emergency Departments:
Optimising Use of Pethidine
A Multi-centre DUE Project
Coordinated by NSW Therapeutic Assessment Group
Funded by National Institute for Clinical Studies
Workshop Outline
Background and project overview
Ms Karen Kaye, Executive Officer, NSW TAG
The gap between evidence and practice
Prof Ric Day, NSW TAG Project Team
Rational use of opioids
Panel discussion of case studies
Afternoon tea
Effective ways to change practice
Ms Judith Mackson, Prescribing Program Co-ordinator, NPS
DUE: theory and practice - project implementation
Ms Karen Kaye, NSW TAG
Is there a problem?
Prescribing of pethidine in general practice
Prescribing audit in hospitals 2001
Influence of hospital prescribers
Continuity of care
Aims of the Project
Reduce prescribing of pethidine by
50% in each DUE cycle
Conduct 3 DUE cycles during the 12
month project
Set up a sustainable process of review
of pethidine prescribing
The DUE Cycle
The Approach
Use drug use evaluation to improve practice
Audit prescribing of pethidine in a range of
Emergency Departments
Compare prescribing with recognised evidencebased guidelines
Identify and implement interventions to close
the gap between evidence and practice
Collaborate and share experience to help spread
practice improvement
Project Reporting Structure
NSW Therapeutic Assessment Group
Reports to National Institute for Clinical Studies
DUE Support Group
Pethidine in ED Project Group
(hospital co-ordinators)
Clinical Reference Committee
Hospital teams and
Project team
Clinical Reference Committee
Prof Ric Day
Dr Andis Graudins
A/Prof Milton Cohen
Dr Alex Wodak
Dr Robert Dowsett
Ms Kanan Gandecha
Ms Margaret Knight
Mr Stuart Dorkin
Ms Kathleen Ryan
Dr Amanda Alexander
Ms Susie Welch
Ms Karen Kaye
- Clinical Pharmacologist, SVH / NSWTAG
- Emergency Physician, Westmead
- Pain Physician, Darlinghurst Pain Clinic
- Alcohol and Drug Specialist SVH
- Emergency Physician, Westmead
- Pharmaceutical Services, NSW Health
- Consumer
- ED Nurse, Westmead Hospital
- Quality Manager, St Vincents Hospital
- Project Officer, NICS
- ED Pharmacist, Project Officer, NSW TAG
- Executive Officer, NSW TAG
Participating hospitals
Auburn Hospital
Murwillumbah Hospital
Bankstown Hospital
Prince of Wales Hospital
Blacktown Hospital
Royal North Shore Hospital
Mt Druitt Hospital
Royal Prince Alfred Hospital
Grafton Base Hospital
Southern Area Health Service
John Hunter Hospital
Sydney / Sydney Eye Hospital
Lismore Base Hospital
Westmead Hospital
Mullumbimby Hospital
Wollongong Hospital
The process to date
Hospital project co-ordinators nominated
– Institutional approval
– Liaison with hospital teams
– Co-ordination of data collection and feedback
– Co-ordination of education / interventions
– Reporting back to hospital committees & CEO
 Pragmatic approach – minimal data collection
 Data collection form prepared
 Data collection process piloted (3 sites)
Workshop Goals
Provide a forum for hospital coordinators and
team members to meet
Clarify goals, objectives and project plan
Encourage input and feedback from teams
Clarify support requirements
Discuss issues of concern