Page 129 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP4.6 Clinical Safety and Quality Service II 16:15 Room 221

Enhancement of Pharmacy Services Following Implementation of Inpatient Medication Order Entry (IPMOE) Monday, 18 May
System at Prince of Wales Hospital
Lo IFI, Shuen YPC, Ng SP, Wong KWJ, Lee SCB
Pharmacy Department, Prince of Wales Hospital, Hong Kong

Introduction

Inpatient Medication Order Entry (IPMOE) has been implemented at Prince of Wales Hospital (PWH) since July 2014. The
instant transmission of electronic orders has completely replaced facsimile orders which is not only environment-friendly but
also provides updated and complete medication profile for pharmacists’ early verification. Clinical intelligence checking and
other advanced features, in addition to the adoption of 2D barcode for drug identity checking before administration, definitely
enhance medication safety. The automatic prioritisation of orders according to urgency and administration due time (ADT)
further streamlines drug distribution process and facilitates clinical operation. Pharmacy has re-modelled dispensing process
and drug delivery system with the aim to maximise benefits of IPMOE and pursue timely delivery of right medications to right
patients.

Objectives

To review verification pattern of IPMOE orders by pharmacists and drug distribution in relation to ADT. Primary outcomes
include verification patterns with respect to prescribing time and delivery performance of completed orders to wards before
ADT. Secondary outcomes include prevalence of replenishment request (RR) outside routine supply.

Methodology

A retrospective quantitative analysis of inpatient orders for medical and surgical specialties processed by PWH pharmacy.
Data in November of 2013 and 2014 are collected as pre- and post-IPMOE period.

Results

Pharmacists were able to verify all order types including new, modified and refill for both individual patient drug (IPD) and
wardstock (WS) with an increase of 63% in number of orders verified (total 80,595 item per month). For new IPD and WS
(n=34,716), pharmacists verified 71% and 86% of orders within 30 minutes and 60 minutes after prescribing respectively.
For drug delivery of new IPD (n= 17,348), 27% of orders were transmitted to Pharmacy after ADT and no evaluation could
be performed. The other 58% were ready for delivery before ADT (of which 54% were >1hr before ADT) and 15% were late
for sending out. These late orders are found prevalent at 7:00 to 8:00 am and 5:00 to 7:00pm after clinical ward rounds. For
RR, 1,275 requests per month were captured post-IPMOE and 95.3% was claimed due to insufficient stock. Majority of
requests were made at 7:00 am and 7:00 pm. The above findings require further review on pharmacist support, drug delivery
arrangement and clinical practice so as to uphold safety and efficiency.

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