April 15, 2020

New ‘Partnered Pharmacist Medication Charting’ model

Towards the latter half of the year, Northern Health Pharmacy will be implementing the Partnered Pharmacist Medication Charting (PPMC) model. This will allow for a more collaborative approach to improving patient care through the quality use of medications.

Carol Ly, Deputy Director Pharmacy explained this model was developed to reduce the incidence of medication errors in an acute setting.

“At the moment, doctors are only able to chart the medications that the patient presents to hospital with. The pharmacist then checks with the patient  and gets the full medication history. The pharmacist would also call the patient’s pharmacy, do the best possible medication history and check against the chart, identify problems and work with the doctors to fix it,” she explained.

The issue with that approach arises when, for example, a patient presents to ED with just one medication, and is unable to communicate what else he or she is taking. The medical team would chart that one medication, even though the patient might be on five regular medications.

“The new program would enable a pharmacist who has completed the PPMC competency training package and credentialing, to chart pre-admission medications, new medications and venous thromboembolism (VTE) prophylaxis in collaboration with the treating medical doctor, for patients admitted to either an emergency short stay unit or a general medicine unit,” she explained.

Deanna Guy, Deputy Director Pharmacy, added that the idea is the pharmacist do the medication reconciliation and chart the medications themselves. With documentation of an accurate, best possible, medication history and medication reconciliation occurring on admission, patients will be more likely to have the correct medications charted from day one of the inpatient stay.

“It’s about being there from day one and assisting the doctors with getting things charted correctly from the beginning. This would allow nurses and doctors to focus more on patient care, as the drug chart is only one part of overall patient care,” she added.

“It is about being more proactive, rather than us coming and fixing medication charts later,” she explained.

The process would include the pharmacist having a conversation with the doctor and saying “these are the medications the patient is currently taking, are there any other medications you wish to add to the list?”. Then the pharmacist would get a full sign off from the medical team and nurses can administer from their order.

“It’s about improving medication safety and decreasing errors.  We were hoping to start in June, but due to COVID-19 pandemic, the initiative got delayed to potentially August,” she explained.

This team-based approach between medical doctor and pharmacist allows for better integration of the skills and expertise of pharmacists into the multidisciplinary team, whilst also streamlining the prescribing process, avoiding duplication of work and potentially reducing the risk of medication errors. In other health services, this system has proven to save money and decrease length of stay.

“Through the implementation of PPMC, we are hoping to introduce sustainable practice changes that increase workforce integration and satisfaction whilst, most importantly, improving the quality and safety of care for our patients,” Carol added.

Featured image (left to right): Deanna Guy and Carol Ly