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ConferenceImplementation Science

The impact of an extended-hours pharmacy service in the Emergency Department (ED) of a tertiary hospital

By October 29, 2018 No Comments

By Caitlin Lock, Master of Philosophy Student

I recently attended the International Forum on Quality and Safety in Healthcare, in Melbourne. The conference brought together clinicians, academics and leaders in quality improvement and patient safety from more than 30 countries.  Jointly organised by the Institute for Healthcare Improvement (IHI) and BMJ, keynote speakers included Don Berwick, President Emeritus, IHI; Derek Feeley, CEO and President, IHI; Fiona Godlee, Editor-in-chief, The BMJ; Jason Leitch, National Clinical Director, Scottish Government; and Euan Wallace, CEO, Safer Care Victoria.

The theme of the 2018 International Forum was Connect. Co-Create. Communicate. The programme highlighted the importance of collaboration between patients, frontline staff, and management, and the need to support and empower clinicians to drive improvement initiatives.

Over the three days, it became clear that the convergence between Improvement Science and Implementation Science is increasingly recognised. The classic methods of improvement such as PDSA cycles and stakeholder engagement are being complimented by the psychosocial concepts of change that implementation science brings. Meanwhile, Implementation Scientists are finding in Improvement Science well-tested tools and processes to facilitate change. Experts on both sides of the academic divide have found that some of the greatest challenges in implementing evidence-based innovations or quality and safety improvements are understanding the psychology of change, sustaining change, and scale-up and spread of successful change projects.

I was fortunate to have the opportunity to present my Master of Philosophy research in the three minute thesis-style “Perfect Pitch” competition. My research is looking at the impact of an extended-hours pharmacy service in the Emergency Department (ED) of a tertiary hospital. Medications contribute to up to 30% of hospital admissions, costing the Australian healthcare system up to $1.2 billion annually. Pharmacists in ED can identify medication-related problems at the front end of a patient’s hospitalisation, and make recommendations to resolve or prevent adverse events. In addition to the clinical and operational benefits, I’m delving into the drivers of clinician behaviour and how this facilitates pharmacist involvement in multidisciplinary patient care in the ED. The next steps will be using these insights to facilitate scale-up and spread to more EDs to reduce medication-related problems and improve patient care.