The Pharmaceutical Journal
Vol 269 No 7206 p60
13 July 2002

Hospital care winner

Pharmacist’s input into heart failure team reduces readmissions

Improve outcomes — add a pharmacist to the heart failure team

Janet Lock, MRPharmS (medical directorate pharmacist), Carl Brookes, MRCP (consultant cardiologist), Marie Hurson, RGN (clinical nurse specialist), North Hampshire Hospitals NHS Trust, Basingstoke

The publication of the National Service Framework for Coronary Heart Disease provided the impetus for a multidisciplinary team at North Hampshire Hospitals NHS Trust to set up a heart failure service which opened its doors in December 2000. The service was intended to be run by two clinicians, a nurse and a cardiac technician. However, a hospital pharmacist approached the team and demonstrated that she too could play an essential role because drug therapy was an important component in the management of heart failure.

The winning project was presented by Janet Lock, medical directorate pharmacist, who described, in general, how the service works and, in particular, the impact of having a pharmacist on the team. Ms Lock explained that after the clinician's examination of the patient, she works closely with the clinical nurse specialist to provide patient-focused and individualised drug management. The service provides education, support and counselling to patients and carers, management of medication compliance and lifestyle changes, initiation and titration of medication under agreed protocols, monitoring for side effects, ordering of blood tests when necessary, referral of patients to other health care professionals such as a dietitian, and liaison with the primary care team, including GPs.

"The philosophy behind the project is to empower patients so that they do not feel so helpless," said Ms Lock.

Since the implementation of the service, the hospital has demonstrated a significant reduction in admissions and readmissions for heart failure patients. — Contributed by Diane Langleben, editor, Hospital Pharmacist.

Hospital care finalist

Medication error reporting scheme helps target training and education needs

Reducing medication errors with a real time web-enabled hospital incident reporting system

Damian Child, MRPharmS (principal pharmacist, clinical services), Paul Moore (clinical governance manager), Jonathan Cooke, MRPharmS (director of pharmacy), Selwyn Roberts, FRCA (consultant anaesthetist), Ray Burdge (computer services manager), South Manchester University Hospitals NHS Trust

Damian Child, principal pharmacist, clinical services, described the development of the web-enabled hospital incident reporting system (HIRS) which has been in place at South Manchester University Hospital since spring 2001. The HIRS provides the trust with a clear framework to identify, report, manage and prevent clinical and non-clinical adverse events. Any staff member with authorised access to the trust intranet can report incidents and near misses by means of a simple form. Details go to a database managed by the trust clinical risk department and are reviewed to see what lessons can be learnt and what further action needs to be taken.

Mr Child said that they have found that in the period April 2001 to May 2002, there were 195 medication-related reports, of which 134 (69 per cent) were near misses.

One benefit of the system has been not only to show that staff need more training, but also to help target training and education needs. — Contributed by Diane Langleben, editor, Hospital Pharmacist.