Award-winning continuity of care

29 November, 2011

A program making the transfer of elderly patients from hospital to residential care facilities safer has been lauded at the 2011 Victorian Public Healthcare Awards.

MedGap: Improving continuity of medication management on discharge to residential care was developed by a team at Monash University's Centre for Medicine Use and Safety (CMUS) and hospital partners. The program took out the Excellence in Service Provision category at the recent awards ceremony.

Rohan Elliott of CMUS and Austin Health led the development of the program after an audit found that one in five patients experienced a medication error during the transfer from hospital to residential care.

"Problems with medication, such as missed doses, usually arose because there was no up-to-date medication chart available at the facility when the patient arrived there," Elliott said.

"Patients were taking an average of eleven different medications and required a dose within four hours of arriving from hospital. Without a medication chart staff at the residential care facility were unable to administer drugs and had to wait for the patient's GP to attend the facility. However, GPs are busy and patients were waiting anywhere between six hours and three days for a visit. In about 33 per cent of cases, a locum doctor had to be called in to write the chart."

MedGap addressed this problem by having the hospital pharmacist prepare medication charts prior to discharge, allowing patients' drug regimes to continue uninterrupted. The interim chart provides additional information, such as the time of the last dose of each medication in hospital.

"The main goal was to reduce the number of missed doses by providing facilities with an interim medication administration chart on discharge," Elliott said.

"We also wanted to reduce the pressure on residential care staff by lessening the need for urgent medical attendance at facilities just to provide a medication chart.”

The program has been rolled out across all campuses of Austin Health, with about 140 interim charts being produced per month. It has also been implemented at several other hospitals in Victorian and Queensland.

An evaluation of the program found that medication errors had fallen to two per cent, and locum attendances to 11 per cent. Feedback on the new system from facility staff and GPs was overwhelmingly positive, with GPs indicating that the chart should be standard practice across all hospitals.

The MedGap project was a collaboration between CMUS, Austin Health, Northern Health and North East Valley Division of General Practice, with funding from the JO and JR Wicking Trust.

Source: Monash University