We recently interviewed three Australian hospital leaders to discuss their insights and opinions on the implications of the (NSQHS) Standard 4 – Medication Safety.
Peter Williams, Manager Governance and Education, St. Vincent’s Aged & Shared Services, St. Vincent’s Health Australia
Bonnie Tai, Acting Assistant Director of Pharmacy, The Prince Charles Hospital
Vaughn Eaton, Director, Flinders Medical Centre and Noarlunga Health Services and SA Pharmacy, SA Health and Government of South Australia
The standard sets out to ‘ensure competent clinicians safely prescribe, dispense and administer appropriate medicines to informed patients and carers’.
The criteria to achieve the standard include:
- Governance and systems for medication safety
- Documentation of patient information
- Medication management processes
- Continuity of medication management
- Communicating with patients and carers
Download your copy of the Guide to Standard 4 Medication Safety
[CC] What are the biggest implications of the (NSQHS) Standard 4 – Medication Safety?
Peter Williams – ‘From a Private Hospital perspective, the NSQHS have provided clear and directional governance expectations surrounding Medication Safety that supports a collaborative approach with our contracted Pharmacy provider, patients and family.’
Bonnie Tai – ‘The NSQHS Standard 4 – Medication Safety has provided healthcare organisations a comprehensive, holistic framework for quality improvement in medication management and safety. It ensures all aspects of the medication management cycle (regulatory, administrative, safety & quality, clinical) and all the people that are involved in the cycle (clinicians, patients, hospital administrators) are being considered by healthcare organisations in their service delivery.’
Vaughn Eaton – ‘The requirement to meet all elements of the NSQHS Standard 4 should be embraced as an opportunity for an institution to reflect on their current medication safety systems and introduce novel initiatives to enhance patient care. In doing so, the team should view accreditation not as an obstruction, but an avenue by which collaboration between professionals, consumers and executives can make positive improvements to the level of care we provide. There is a significant commitment in terms of resource to meet the elements of each standard, with obvious penalties of non-accreditation if not met. The process, however, should not be viewed as a burden – but the opportunity to start early and work in partnership with colleagues.’
What are the 3 most important strategies you will implement to ensure your institution meets the accreditation standards?
- Clear and accurately recorded medication history
- Medication reconciliation on admission / discharge has driven internal quality improvements to strengthen this process
- Improved communication with the patient / family and GP’s regarding medicines and ongoing care
- Healthcare organisations must meet the legislative requirements for medication management, ensuring medications are handled and stored securely that only authorised personnel may have access to medications.
- Healthcare organisations need to implement sustainable mechanisms to assess and monitor (a) the existing medication management system, particularly in relation to high risk medications and processes, and (b) the effects of change as result of quality improvement activities.
- Clinicians should actively communicate and engage with their patients regarding their options, risks and responsibilities for medication management during the episode of care.
- Allocation of a dedicated resource to co-ordinate the accreditation standards
- Establishment of a committed multi-disciplinary “standard 4” team who meet regularly and develop an action plan
- Start now!
How could Medication Safety be improved?
Peter Williams – ‘Provide deeper educational opportunities (that are patient and front line clinician driven) for all healthcare employees on risks, prevention strategies and safety initiatives .’
Bonne Tai – ‘One of the most important strategies to improve medication safety is to incorporate the principles of healthcare safety and quality as a key component in the university curriculum for medicine, nursing and pharmacy. It is crucial to inspire our new generation of clinicians to lead and contribute to the provision of safe, effective and appropriate healthcare services for all Australians.’
Vaughn Eaton – ‘Collaboration and acceptance that medication safety is the responsibility of all health professionals to deliver a safe medication management system to our patients, with supportive governance process in place. The ability to have a dedicated resource is critical to ensure the ongoing develop of safe operating systems are introduced, monitored and enhanced on an ongoing basis. The involvement of consumers is an important factor to consider ensuring we deliver the safe level of service that we expect of from ourselves as individuals, but also what is expected of the patients we serve.’
What’s your view? We’d love to know your three most important strategies to ensure your institution meets National Standard 4?