Pharmacist team who are supporting frail patients who attend the Emergency Department shortlisted for national award
Our pharmacy team has been shortlisted for a prestigious national award for improving safety and quality of care for frail patients attending the Emergency Department at Royal Derby Hospital, through an innovative ‘joined-up’ approach.
Frail or 'Frailty' patients are weakened by aging which means they usually have multiple and complex health needs. This means that urgent and quick assessment of their medication is key to making sure they receive the right care, treatment and better health outcomes.
In this trial, pharmacists in the frail emergency assessment team (FEAT) at RDH based themselves with other clinical teams in ED to offer additional support to frail patients and complete a comprehensive medication review of patients to help to enhance their recovery following a hospital admission. The review helps pharmacists decide the best treatment for patients and ensure they are receiving the correct and most optimal medication.
They usually work in the medical assessment unit (MAU) where they treat fail patients coming from ED, but as part of this trial, based themselves in ED to support faster patient assessment, aid in swift patient recovery and avoid future admissions.
Other benefits to the project include reduced bed stays and cost savings due to a reduction in the number of medicines prescribed, but the most notable improvement has been to patient experience, with the changes allowing the team to optimise patient care and facilitate safe discharge, meaning patients are cared for quicker and on the most effective medication, helping to prevent readmissions.
Louise Organista, Advanced Clinical Pharmacist in the FEAT team, said there was a positive response to the trial from the outset:
"We found that 92% of patients required some sort of pharmaceutical intervention which ranged from de-prescribing medicines which were no longer optimised needed or safe for that patient, to supporting with prescribing. We were also able to assist our physiotherapy colleagues if patients needed support with pain relief to aid their physio assessment or after a fall and required some medication to get them home. All of these interventions showed there was a need for a pharmacist-led medication review in ED.
"It was important to us that whichever department the patient was being treated in came to us, they received the same service, but we wanted to be able to offer patients a face-to-face review and work with them to identify their needs as soon as they entered the emergency department."
The multi-disciplinary team also works with community partners and is able to refer to primary care for further support if they need it.
Louise said: "We were able to support faster and more timely discharges and when we followed up with patients six weeks later we found that in 65% of cases the GP had received our discharge medication plan and had followed our points on how to optimise that patient's medicine, which was really reassuring to us, to see our work followed up and the patient benefiting from that collaboration."
The initiative stared in June 2023 and the team now works in ED and seeing more than 70 patients a month in the department who require pharmacist involvement, while the number of patients being treated by them in the MAU has reduced.
Louise said: "This reflects how we are trying to see patients right at the front door which is our NHS priority in terms of serving the needs of our patients with frailty.
"As pharmacists we are medication experts and able to identify risks of harm with medicines so not only does this allow us an opportunity to offer patients the correct medication for them but we are also able to reduce harm and ensure they are getting the right treatment for their needs."
The impact of this work has seen the team shortlisted in the Urgent and Emergency Care Safety Initiative of the Year Award at this year's HSJ Patient Safety Awards - which acknowledges hard-working teams and individuals across the UK who are continually striving to deliver improved patient care.
Two other teams from UHDB have also been shortlisted for the awards, which will take place on Monday 16 September.
Joining the frailty team in their category are the Medical Same Day Urgent Care team for their work to help patients avoid being admitted for a hospital stay when attending our emergency department at Royal Derby Hospital. While the Medicines Optimisation team has been shortlisted for the Improving Medicines Safety Award category for their collaborative work with Digital Services to develop an interface that improves communication with community pharmacies.