021 Data Quality: Prescribing

021 Data Quality: Prescribing

Notes
This folder is part of 021 Data Quality

Overview



Medication active but not issued

This set of 3 searches are designed for clinicians to look at medication which has been sitting on a patient's current medication list without being issued. Demonstrating that this housekeeping activity is done regularly could be used to demonstrate to CQC how the organisation is safe.
  1. Medication active but never issued addresses an EMIS design problem whereby a medication which has been added but not issued straightaway will remain on the active list until a user ends it. This is unlike medication which has been issued where the default settings will automatically move it to 'Past' after 28 days for acute, or 12 months for repeats. Use the report to sense check when the medication has been added and determine whether action needs to be taken to remove the medication.
    The search is designed to ignore any medication which was added in the last 4 months, in case this is waiting for a specific time to be issued. Using a relative run date 3-4 months in the future will pick up medication added recently.
  2. Medication active but not issued identifies patients with drugs on their (repeat) lists which could be issued but has not been for at least 6 or 11 months. Whilst there will be some seasonal medications that are picked up by these searches and reports, there may also be medications left on which should not be there, perhaps having been replaced by an alternative.
    The 11 month timeframe has been deliberately selected to ensure there is a final chance to review medication lines before they are automatically ended 12 months after the last issue. 
    Medication added with an issue method of hospital will be included in these searches.

Medication review dates

For Practices using the medication review diary date system, one search is designed to flag anybody with active repeat medication who does not have a diary date. A diary review date can be added so due or overdue reviews can be flagged by searches or alerts. The second search finds patients who do not have any active repeat medication, but still have a diary date - these diary dates can be removed to prevent the patient being included in searches or overdue alerts.

EPS nominations

For dispensing practices, Dispensing patients with an EPS nomination finds those patients with active medication who are marked as a dispensing patient, but have a primary EPS nomination. The dispensing flag will prioritise sending medication to the dispensing queue rather than sending prescriptions electronically. Each patient should be reviewed carefully to validate whether the EPS nomination was accidental or a one-off (ie: when the patient was on holiday), or the patient has decided to collect their prescriptions from a pharmacy.
Idea
Changing the dispensing flag to 'No' will prevent delays to the patient being able to collect their medication. Some detective work may be needed to determine exactly what the patient wants to do. Nominations for pharmacies elsewhere in the country may point towards holiday nominations, which may be confirmed by recent consultations or tasks. 

Appliances

This serves as a register for all patients with an active appliance medication (eg: catheter, stoma, ostomy devices and accessories). The report displays any nominated appliance pharmacy. Identifying patients without a nominated appliance pharmacy irrespective of dispensing status, then adding a nomination could reduce administrative overheads communicating with the appliance contractor, and speed up the turnaround time for the patient.

Prescribed both COCP and POP

Patients with both COCP and POP contraception on their active medication list. Clinicians should review any patients flagged and take appropriate action to remove one of the medications, probably left on when switching medication.




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