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Title To reduce Outpatient Pharmacy PhOne Interventions (OPPO) |
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Type Oral Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Quality Improvement Research |
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Main Author Xin Ying Tay1 |
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Presenting Author Xin Ying Tay1 |
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Co-Author Kheng Yong Ong1 Yan Zhi Tan1 Susan Suyu Lim1 Giat Yeng Khee1 Choon Siang Ho1 Lina Hui Lin Choong2 Marjorie Wai Yin Foo2 Mei Ying Ng1 |
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Department / Institution / Country Pharmacy / Singapore General Hospital / Singapore1 Renal Medicine / Singapore General Hospital / Singapore2 |
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Abstract Content: Introduction, Method, Result, Conclusion Introduction: Pharmacists are integral members of the healthcare team and work with physicians to optimise patient care by identifying and resolving drug-related problems, usually via phone interventions. However, phone interventions can also be due to other reasons. These include patients' requests for medications used on a “when necessary” basis, switching of medications due to financial or administrative issues and clarification of ambiguous orders. These interruptions may compromise patient safety and reduce efficiency for both physicians and pharmacy staff. At the Singapore General Hospital, an average of 942 phone interventions was made at the Outpatient Pharmacy, of which 40% were with the Department of Renal Medicine. Further analysis revealed that approximately 59% of all calls may be potentially avoidable. The objective of the project was to reduce avoidable phone interventions made to Department of Renal Medicine by 30% in 12 months. Method: Plan-Do-Study-Act (PDSA) cycles were used for solution implementation. PDSA 1 involved staff and patient education. In PDSA 2, an "order-on-behalf" protocol was developed for pharmacists to add or substitute selected medications, as well as to extend duration of prescriptions without contacting the physicians. PDSA 3 involved physician education on recommended prescribing habits , common ambiguous orders and appropriate order selection in the prescribing system. Result: Over a period of 6 months, the protocol was utilized 52 times, with a monthly reduction of 76 avoidable phone interventions observed. This resulted in 514 phone interventions avoided, which translated to 86 man hours saved. Conclusion: The initiatives were effective in reducing the number of potentially avoidable phone interventions, thereby improving the overall efficiency in prescription processing. The initiatives have been incorporated into daily operations. Data analysis three months post-implementation has shown sustainability of results. Future plans include extending the order-on-behalf protocols to other departments, expanding the scope of the current protocol.
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