April 1st 2009 to March 31st 2010

100Audit ImprovementFor all prescribed drugs, omission without reasonor appropriate action should be avoided. Allefforts should be made to ensure patients receiveall medicines as prescribed to ensure that theefficacy and safety of their care is maximised. Itis apparent from the outcome of the audit thatthe correct omission codes are not being utilisedwithin clinical practice. This practice increases thepotential for medication errors to occur withinour wards causing potential harm to our patients.Medication errors have serious consequencesto the wellbeing and recovery of our patients.Documenting an incorrect code is a medicationerror, which should be reported via usualUntoward Incident Reporting Systems.Documenting a code without ascertainingthe facts e.g. recording a code 6 which is inrelation to when the patient is unable to selfadminister or when the patient does not have themedication is not only an error but a falsificationof patient records.Despite this, the results highlight that there issome room for improvement. All staff involvedin medicines administration are encouraged toreflect on current practice and identify areas forimprovement.All Divisions have been supplied with electronicaudit results for individual wards, it is anticipatedthe audit will be repeated within an agreed time.The PD Sister is available to all wards that requireadvice, support or educational sessions.The importance of correct documentationand omission coding is included in trainingpackages at induction and ongoing professionaldevelopment for Trust employees.A future Medicines Matters bulletin is plannedto highlight the correct documentation processesrequired to provide safe medicines administrationand management within the Trust.This will be disseminated to all areas viaMedicines Management Liaison Links and generaldistribution lists.This practice was reviewed and practice auditedprior to the introduction of a National PatientSafety Alert issued in Feb 2010 RRR009 Reducingharm from omitted and delayed medicines inhospital, which reflects the findings of the audititself.Action has already been taken in the provision ofTraining and Clinical Support for staff in clinicalareas as the Trust continues to improve patientsafety in relation to safer medicines managementwithin the Trust.Blackpool, Fylde and Wyre Hospitals2.1.2 Clinical EffectivenessNorth West Advancing Quality InitiativeThe Trust is one of the first sites to assist in thedevelopment of the North West Strategic HealthAuthority Advancing Quality Programme, whichfocuses on delivery of a range of interventionsfor each of the following conditions examples ofthe interventions can be found in the followinginformation and tables:• Acute Myocardial Infarction (Heart Attack)• Hip and Knee Replacements• Coronary Artery Bypass Graft• Heart Failure• Community Acquired PneumoniaResearch has shown that consistent applicationof these interventions has substantially improvedpatient outcomes resulting in fewer deaths, fewerhospital readmissions and shorter hospital lengthsof stay.Applying all the interventions will support ourgoals of reducing hospital mortality, reducingpreventable harms and improving patientoutcomes, thereby improving the quality of theirexperience. The Trust is on track to achieve top25% performance for Acute Myocardial InfarctionMeasures and top 50% performance for Hip andKnee. Work is ongoing to improve and implementmeasures and achieve top 25% performanceacross all conditions. Approximately 2,700patients a year will benefit from this programme.The Patient Experience aspect of the AdvancingQuality programme is now being measured. Assoon as robust data is available the Trust willidentify and implement any actions required toimprove the patient experience.Comparison of DataFor each of the key areas (a series of appropriatepatient care measures have been determinedwhich are known as Composite of Score (CQS).Data is collected to demonstrate if thesemeasures are being met and a composite qualityscore for each key area is derived for everyTrust in the programme. From this data theperformance thresholds for top 25% and 50%performance are identified and applied to eachTrusts performance).Trusts in the top 25% performer group willreceive an incentive payment of 4% of tariff,whilst Trusts in the top 50% performer group(who are not in top 25% group) will receive anincentive payment of 2% to be used to improvepatient care.