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19 Mar 2024

Enhancing Governance and Efficiency: CHFT's New Electronic Controlled Drugs Solution

Solidsoft Reply Stand: K52
Enhancing Governance and Efficiency: CHFT's New Electronic Controlled Drugs Solution

Challenge

Recording of controlled drugs, their supply and administration, is a highly regulated process. Whilst the standards are clear, human error in terms of the recording of CD transactions can occur, especially in view of the number of transactions that take place daily in a busy hospital every day. CHFT, in a similar position to other Trusts, had reported, following inspections by both the local Trust CD audit staff and the Care Quality Commission (CQC), some issues with documentation in the paper controlled drugs (CD) registers. These included:

  • Level of accuracy and completeness of CD documentation for receipt and administration of CD stock.
  • Crossings out on register lines which made some entries difficult to interpret.
  • In some theatres, records indicated that while dose administrations were accurately documented, the recording process may be occurring later than immediately after doses were given, rather than near real-time.

Despite conducting internal bi-annual compliance checks across the Trust and providing additional training and induction events, along with regular reviews of the medicines policies, the similar issues persisted, prompting The Trust’s controlled drug accountable officer (CDAO), to focus efforts and consider options for how to help staff avoid these issues.

The Trust’s CDAO, Lis Street, said: “With COVID and other recent events it made us look closer at how we could make things more straightforward for staff both to order CD stock for their wards from pharmacy and also record CD receipt and administration."

Approach

Lis Street said: “Previously the majority of CD stock and administration transactions was very paper intensive - in addition to paper CD registers and CD requisition books, our CD audits also relied on scanning paper audit sheets and then emailing them between pharmacy and clinical managers to inform them of audit outcomes challenging to keep track, so we knew digital was the way forward.”

After exploring the market for a CD management solution, CHFT found that most options were geared towards community pharmacies and did not adequately address acute trust requirements. Whilst the community version enabled simple transactions i.e. booking in and out CD stock, it did not enable the documentation of all the hospital required CD transactions, such as patients’ own CDs, use of part doses in theatre and witnessing of CD destruction.

The Trust decided to develop a CD management solution with the involvement of their medicines management team and pharmacy staff throughout the whole development. CHFT also enlisted a software development partner, Solidsoft Reply, to guide them through the technical aspects of the project.

Solidsoft Reply’s extensive experience in implementing solutions across the healthcare sector and proficiency in building systems tailored to clinical usage, made them the ideal partner for the project. Together, Solidsoft Reply co-designed eCDR-Pro, a Microsoft Cloud web-based solution alongside clinical professionals at CHFT. This cutting-edge solution leverages the latest Microsoft Cloud technologies, including Azure Front Door, App Services, Azure SQL, and Azure Active Directory.

Solidsoft Reply’s Partner, David Eccles said: “Right from the start, we made a conscious decision to co-design a Microsoft Cloud solution together with the Trust; to build a solution that was easy to use, provide full auditing capability and all times provide unambiguous safe custody of CD’s.”

The key mission was to create a solution that could effectively free up nursing time and improve governance, especially avoiding crossings-out in the registers. Additionally, it was imperative to incorporate robust auditing functionalities to safeguard the integrity of CD registers.

Results

It took two years to arrive at a complete solution that met all the requirements and was tailored to the Trust’s needs. Throughout this process, there were several iterations to strike the balance between implementing additional controls and governance measures without the burden of additional work on pharmacy and clinical staff.

This solution includes mandatory fields for data entry, recorded administration times for CDs, allowing for a precise and accurate reflection of when these have happened rather than being recorded at the end of a day. This ensures transparency and accuracy, allowing us to track the dose administrations. Additionally, signatory and witnessing rules were put in place to ensure secondary checks are performed and documented.

Since the early part of 2023, we have been rolling out eCDR-Pro across the Trust, starting with the Huddersfield site and adding wards and theatres. This transition has removed the need for paper recording, as we progress.

With eCDR-Pro now being in place for over a year deployed across CHFT’s two sites, it is demonstrating significant improvements and time savings for nursing teams. For instance, each ward / theatre now saves over 15 minutes on orders, 10 minutes on stock checks, and 30 minutes on compliance checks every time they are performed. Overall, this amounts to thousands of hours saved per year across the Trust, allowing CHFT to allocate more time and resources to patient care.

In a healthcare landscape where every minute counts, this digital solution has revolutionised CD management by accelerating order processing, seamlessly facilitating compliance checks, and enhancing the healthcare journey. As a result, nursing teams can focus on what truly matters: delivering exceptional care to their patients.

Lis Street said: “We are very proud of the final product, and it exceeds our expectations in terms of the benefits we have seen.”

Solidsoft Reply’s Partner, David Eccles added: “We are immensely proud of our solution, and we are delighted in the amount of positive feedback we have received from the team at CHFT. The area of CD management has more complexity than you can imagine, and we focused a lot on making it simple for staff to use.”

 

Solidsoft Reply

Solidsoft Reply is a leading technology company creating award-winning solutions utilising the Microsoft Azure cloud platform. As a globally acclaimed Microsoft AI Cloud Solutions Partner, we specialise in GS1 traceability systems worldwide, crucially ensuring the authenticity, legality, and safety of our customers’ products and services. Serving non-profits, NGOs, healthcare, and the pharmaceutical industries, we deliver technology for positive social impact. Your products, safe in our hands.

Calderdale and Huddersfield NHS Foundation Trust (CHFT)

Calderdale and Huddersfield NHS Foundation Trust (CHFT) provides a range of services, including urgent and emergency care, medical, surgical, maternity, and outpatient services. CHFT serves over 113,000 inpatients annually and continues to modernise and invest in health services to build on their strong reputation. As a foundation trust within the NHS, CHFT leads in improving healthcare quality, ensuring patients' needs are met while striving for excellence and patient-centric care.

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