Improving the supply of critical medicines from pharmacy to reduce the delay in medicines administration on wards

It is nationally and locally recognised that doses of critical medications are missed or omitted on a daily basis. This has been highlighted by a National Patient Safety Agency alert published in 2010. Since then Sheffield Teaching Hospitals NHS Foundation Trusthas introduced initiatives to tackle this problem, but there are clear indications that further work is still required. The aim of this service improvement project was to improve the availability of critical medications on the ward to ensure they are available thirty minutes prior to the next scheduled dose. Two plan–do–study–act cycles were undertaken over a 14-day period (January/February 2020) to reduce the time taken for critical medications to be supplied to the ward after a request was placed on the eOrdering system, on one care of the elderly ward. Medication request and prescription tracking data were captured during working hours each week (Monday to Sunday) and examined. The time taken for a request to be processed was captured. Following the introduction of a critical medicines checklist in the pharmacy dispensary and later a flow chart on the ward, availability of critical medication on the ward rose from 89% to 93%. However, the project did not meet the project aim of ensuring 95% of critical medications requested were available on the ward. The project highlighted that for sustainable and robust improvement, the electronic prescribing system required improvement rather than change in the work processes of the ward and pharmacy professionals.