on the ward stock list . This function allows to automatic orders to be generated when a non-stock medicine is ordered by a prescriber and was adapted to manage ward order requests for CDs .
FIGURE 1
Ordering file created and placed on HEPMA ward list
Order file creation A HEPMA new patient record was created and named appropriately for each unique ward that introduced the CD ordering system . This record was placed on the ward HEPMA list ( manually admitted ) which then became the ward ordering record that would hold the details of orders placed and orders completed ( Figure 1 ).
A separate suite of controlled drug files was created within PSC and HEPMA to reflect standard pack sizes , thus aiding ordering and supply . These files were prefixed to allow easy identification by ward and pharmacy staff alike . A HEPMA single selection protocol ( ordering bundle ) was created and allowed all CD ordering drug files to be nested within this . A process was developed using a standard operating procedure to allow a rapid but standardised method of creating the CD ordering files and protocols .
Permissions and governance User permissions were created to limit access to the ordering of CDs . An access request template was produced which required completion by the charge nurse of the area . Each nurse was granted access according to this request . A 3-minute training video and nurse quick-guide was developed to provide learning on how to use this new process .
Webpage creation and pharmacy process A crystal report was written and scheduled to an internal webpage using CRD ( crystal reports distributor ). This pharmacy-only restricted intranet page allowed staff to be prompted when an order was placed . Notes could be entered on HEPMA records beside each order request to update the status of the order . This was designed to create a task overview for the supply process . The non-stock supply process RxSelect was used to generate issuing paperwork which was included with the supplied medicine ( Figure 2 ).
Roll out A phased roll out was commenced and coordinated by pharmacy and charge nurses . Early adaptor wards were chosen based on service need and to ensure the acceptability of the process .
RESULTS
A successfully designed and tested process for ordering CDs was introduced in March 2020 . Test of change methodology was used to improve and refine the performance and usability of the tool . Training and education were made available by the same date via a locally available training video and Quick Reference Guide .
Ward uptake progressively increased from March 2020 and allowed all ‘ Red ’ COVID wards to use the electronic ordering system within one month of implementation . Technical set up and user permissions were managed for each ward by members of the HEPMA team without additional resource . All wards ( regardless of COVID status ) were permitted to implement this system as experience and confidence in the process grew ( Figure 3 ).
To date , the electronic CD ordering process is live in 95 % of inpatient wards . As wards implemented the process , the overall number of paper order requests fell proportionally so that almost all orders ( 98 %) were placed electronically at 5 months ’ post-implementation ( Figure 4 ).
Due to the inherent immediacy of the order request , the pharmacy departed are alerted to electronic orders as soon as
FIGURE 2
Intranet webpage shows the status of incoming requests hospitalpharmacyeurope . com | Issue 100 | 11