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OVERVIEW

University Hospitals Birmingham NHS Foundation Trust has implemented an e-Prescribing and Medicines Administration System, utilising its in house developed PICS application (Prescribing Information and Communications System) to safely prescribe, administer and review all patients that receive care.

THE TRUST

University Hospitals Birmingham NHS Foundation Trust (UHB) is the leading university teaching hospital in the West Midlands and is one of the most consistently high performing trusts in the NHS. During 2012/13, the Trust treated more patients than ever before. It completed more than 585,000 outpatient appointments, 125,000 inpatient treatments and more than 94,000 A&E attendances.

BACKGROUND

With a pioneering IT team in place and funding from the National Institute for Health research, UHB developed the Prescribing Information and Communication System (PICS) in order to record critical information about patients, including the numbers of patients treated, the types of medications administered and clinically relevant interactions and alerts.

THE CHALLENGE

With over 1,000 patients seen every day, over 5,000 members of staff and 32,000 new prescriptions every week, resulting in 137,000 medicine administrations, UHB faced a huge challenge in creating a system which could process the vast amounts of data accurately and consistently. The PICS system needed to assist staff in real time and provide data for analysis which could inform a programme of continuous improvement and clinical excellence.

MORE THAN e-PRESCRIBING

PICS is developed to provide functionality to safely administer and review all patients. The rules-based system uses algorithms to analyse data and inform clinicians at the bedside, about drug interactions, contra-indications and dose limits.

PICS provides functionality to schedule and record vital signs monitoring, recognise deteriorating patients and trigger appropriate alerts to specific teams to support early intervention.

The information generated by PICS also feeds into a number of clinical dashboards which enables nurse managers to safely oversee care across multiple areas, at a glance.

PICS is accessed via mobile tablet computers, computers on wheels or dedicated desktops. The mobile tablets are docked on the wards and there are over 700 of these in use on a daily basis.

THE OUTCOME

Automatic alerts and rules ensure that PICS has made a huge difference to the patient experience. It has improved patient safety, not only by reducing missed doses and inappropriate prescribing, but also by reducing the number of mortalities per year.

Overall UHB can demonstrate marked improvements in patients' safety, efficiency and cost effectiveness on the ward and with the continued analysis of data for research and service improvement purposes, PICS has set the bar for patient care at a very high level.

THE FUTURE

NHS England has been impressed by UHB's ePrescribing and Medicines Administration solution and has been working with the Trust with a view to offering a sub-set of the core functionality- PICS-Lite which consists of modules to support admissions/discharge, clinical decision support, prescribing and medicines administration, nursing assessments and business intelligence dashboards.