Sep 12, 2018

Automated and medicated: How safer system practices are protecting people’s loved ones 

Aged care facilities and services deal in trust.

No matter the level of aesthetic beauty, or wide array of available activities housed within your facility, if you fail to adequately showcase your ability to protect the welfare of your residents, then clients will look elsewhere, as they should.

Medication is an integral part of aged care, and the safe handling, ordering, storage and administration of medicines are vital to the wellbeing of current residents and the future trust of prospective residents and their families.

Indeed, the AACQA Accreditation Standard 2.7 requires that aged care resident’s medication is managed “safely and correctly”.

Unfortunately, many of the processes surrounding medication in aged care have traditionally been paper based, or in the case where they are electronic, the systems used across the pharmacy and the facility are not tightly connected. This systematic breakdown in processes can heighten the risk of mistakes, and takes precious time away from carers who would otherwise be with residents.

With medication playing such an important role in aged care, it follows that pharmacists play a key role in all residential facilities.

Steve Wilson, the owner of Tamar Pharmacy in Ballina, explains that medication often becomes more complicated as we age, and by automating medication systems in aged care facilities and their pharmacies, processes become much more efficient, and the possibility of errors occurring declines.

Medication in aged care: the problems that can arise

The “age-related deterioration of our bodies can make medication regimens much more complicated,” said Mr Wilson.

“In addition, aged care residents may visit a number of doctors, and have specific medication requests – further complicating the work of the pharmacist in aged care.

“Medication decisions are sometimes made by doctors who then leave the facility, which can make it difficult when issues or concerns arise.

“Medication orders can be difficult to read, or poor copies are sometimes made, or the information may be incomplete, and sometimes orders aren’t received at all.”

Conflicts may arise between the software used by the aged care facility to order medication and the software the pharmacy uses, resulting in facility staff not being able to access information and administer medications.

These problems can contribute to delays, and ultimately can lead to an increase in the risk of medication errors.

The causes of medication errors in aged care

Traditionally, most aged care facilities and pharmacies have used different software platforms, Mr Wilson explained. This practice leads to “fragmented transmission” of orders, often using different types of technology where there is little integration.

In many cases, new medication orders still need to be faxed from the residence to the pharmacist.

“Faxed copies of charts are often hard to read and poor quality which increases the burden on facility staff as the pharmacy may contact them more often to clarify information or request further copies.

“Many of the facilities we have worked with have a small number of fax machines at set locations, this can lead to staff delaying sending orders to limit the number of times they visit the equipment.

“This may cause delays when queries arise with orders being processed or the orders not being sent at all,” said Mr Wilson.

And even when orders are received, it can be challenging and time consuming to go back through the client’s information to identify any discrepancies that occur, he said.

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Automated medication systems: quick, accurate, efficient

Best Health Solution’s automated medication system is cloud-based and paperless, meaning that all data is stored centrally. There is one single source of truth for a resident’s medication profile.

“The facility and the pharmacy work on the same cloud-based platform which prevents most of the problems which we have encountered when using different platforms,” said Mr Wilson.

Questions about medication can be more quickly answered because staff have access to all the information through the system – always ensuring a quick resolution, and the GPs can also access the patient’s current profile from the surgery and review changes which have been made, as well as accessing the electronic ‘Doctor Book’ which improves communication and supports the decision making process,” he said.

Orders are received through the system as a picture.

“We receive new orders as pictures via the software which are excellent quality, greatly reducing communication with the facility, reducing the burden on staff,” said Mr Wilson.

“Orders are received much more frequently and much earlier than in the past, he said, and they are often sent as soon as they are complete. This means that orders can be more easily clarified with the prescriber, because they are more often still at the facility when the query arises.

“Primary Medication Charts are never removed, unlike when faxing orders, making it unlikely pages will go missing or be incorrectly replaced,” said Mr Wilson.

“The order pictures can be edited with notes or changes to the order, and any communication that has taken place between staff and the medical team is noted. The file is then saved in the patient’s medication profile, where it is easily accessible should queries arise in future.

“The software also warns the facility if a similar order has recently been sent, preventing duplicate orders and reducing complaints.

“We also use the software for much of the communication between the facility and the pharmacy including new resident information, resident movements and S8 management.”.

Listening to clients, improving communication, reducing errors

Mr Wilson said that implementing Best Health Solution’s automated medication system has reduced the scope for errors and increased efficiency by reducing the amount of communication required between the pharmacy and the aged care facility.

Having a complete “digital trail” of all information sent between the facility and the pharmacy that is quick and easy to access means questions from doctors and staff can be answered quickly – this would “never have been possible with our paper-based system”, Mr Wilson said.

The system has also reduced duplicate data entry and removed human error in a number of areas – removing “multiple major risk factors for medication errors.”

“The products even automatically prevent some errors from occurring,” he said.

“Whether in reducing duplication of data, advising which days require repacking when changes occur, or providing a full digital history of changes, the software reduces the risk of error and increases efficiency.”

“The products have also improved communication between the facility and the pharmacy and within the pharmacy team itself. The facility staff are interrupted less often and know when we ring it is likely to be important.”

“We have had excellent feedback from our facilities using the software and feel it has improved the quality of service we are able to offer.”

To find out more about automated medication systems, contact Best Health Solutions.

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  1. Automated medication systems don’t actually improve medication safety. What improves safety is having properly trained staff who have the time to assess patients and administer the right medication at the right time, etc. The problem with Aged Care is that there is one Nurse for large numbers of patients and these Nurses are doing very large drug rounds where pills are being left with PCAs to administer. PCAs are also administering medications from blister packs because some residents lack the physical dexterity to self administer and the cognitive capacity to know what drugs they are supposed to be taking. This is a recipe for disaster which can only be fixed by Nurse to patient ratios. What is required here is a caring human relationship not an electronic system that makes a bad process go faster.


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