Table 2.2 Evaluation framework Expected outcome Indicator Sub-indicators Measure(s) Potential data sources Activity for data collection Time points for measurement Improved quality and safety in medicines use Reduced AMEs Prescribing errors by number, type, severity, patient volume, total LOS Number of prescribing errors by type and severity Number of patients Number of bed-days Total LOS Medication charts Hospital issues and risk reporting (sentinel events) Review of medication incidents and AMEs of medication charts for a defined time period Review of sentinel events Pre-implementation Post-implementation Ongoing monitoring Administration errors, etc. Increased adherence to guidelines AME = adverse medicine event; LOS = length of stay
Table 2.5 Education and training template Education and training component Requirement Responsibility Duration Cost Self-directed learning Online learning management system and support for the EMM duration Education and training lead 3 months Education materials for the online learning management system Education and training team 3 months Sandpit Build the sandpit environment ICT service provider 1 month Remote access to the sandpit ICT telecommunications manager 1 month Education and training collateral Introductions EMM overview Medication safety Expected benefits Implementation challenges (managing expectations) Education and training team 1 month EMM system training modules Education and training team 3 months EMM demonstrations and presentations (e.g. at grand rounds) Education and training team 2 months Posters and fact sheets Education and training team 2 months (including production time) Evaluation feedback and surveys Education and training team 1 month Trainers 4 people for 1 year Education and training lead 4 months to advertise and fill posts Training facilities 2 rooms for 1 year Education and training lead 3 months to identify and equip Training schedule Overview sessions for all staff Education and training team 1 hour training Education and training team 3 hours EMM = electronic medication management; ICT = information and communications technology
Appendix 4 Example stop/start/continue chart Process STOP —What do you need to stop START — What do you need to start doing? CONTINUE — What do you need to continue doing? ED presentations STOP using paper medication charts START using the EMM system for all ED presentations On admission STOP paper medication charts reviewing the ED medicines on admission CONTINUE medication reconciliation on admission using the EMM system STOP recording current medicines in the progress notes. Mark the progress notes as ‘for medicines information refer to EMM’ or use stickers if they are available START recording current medicines on the EMM system, ceasing or changing medicines as required On discharge STOP making changes to discharge medicines via the telephone START making ALL changes to discharge medicines via the EMM system CONTINUE medication reconciliation on discharge via the EMM system STOP finalising the discharge summary until the discharge medicines are finalised START finalising the discharge summary only after the discharge medicines are finalised CONTINUE to develop the discharge summary as you do now, but do not finalise it until the discharge medicines are finalised START providing the patient with a ‘take-home’ discharge medicines list on discharge ED = emergency department; EMM = electronic medication management