A bespoke, web-based Medicine Management Assurance Audit (MMA) system is replacing a time-consuming, administration-heavy, paper-based way of working at two West Yorkshire hospitals.
It has been developed and implemented over the past two years by a project team from The Health Informatics Service (THIS) for the two hospitals run by its host trust, Calderdale and Huddersfield NHS Foundation Trust (CHFT) – Huddersfield Royal Infirmary and Calderdale Royal Hospital in Halifax.
An MMA is an annual audit for each of the hospitals’ 60 wards/departments, to provide assurance that safe medicines management standards and policies are being upheld.
Previously, each paper-based MMA report was 12 pages in size and required sign off by the auditor and the ward/department manager before it reached the Associate Director of Nursing (ADN), to check the action plan and finally sign off or return it for adjustments.
Karen Austin, CHFT’s Lead Nurse, Medicines Management, says:
“The yearly MMA was developed to give assurance that medicines management standards are being met on wards and in departments.
“It showcases good practice and highlights areas of non-compliance that require assistance to achieve compliance in any of the defined safe practice areas.
“In the past, the MMA had proved to be a clunky process which was reliant on audits to be completed on paper, scanned to the next person, signed, scanned to the next person and so on.
“Achieving turnaround of a fully signed off audit within a month of one being completed, was never achieved.
“It was often many weeks, and sometimes months, later that audits were fully signed off. This rendered the audit ‘out of date’ by the time it was finally signed off.”
Transparency for everyone
The new web-based system provides total transparency for everyone within the MMA cycle, portraying headline information on a dashboard-style home page that can be interrogated.
Rebecca Wootton, THIS’ Web Development Team Leader, who managed the project, says:
“It provides access to all the wards and departments, so with 60 of them across both sites, it is much easier to keep track of what is happening where.
“The users can see when the last audit was completed, how many actions they had, and make sure all the audits have been completed for that year, and how many non-compliances there have been.”
The information can be curated to show trends and year-on-year variances, to provide improved visibility for everyone in the audit trail, especially for wards/departments showing the same non-compliance issues for three consecutive audits.
The system is accessed via each user’s active directory account linked to their hospital account, which means they can only gain access while employed by the trust.
It is based on an email notification system, so anyone included in the audit trail receives update reminders every time something is actioned, with emails on the day and reminders at weekly intervals until all tasks are completed.
Saving time and other benefits
It is estimated the new web-based system is saving each person in the audit trail at least an hour, in addition to time saved on photocopying, scanning and emailing – which usually equated to 10 minutes per action point.
So, for example, if an MMA is processed by four people for each of the 60 wards/departments, that equates to a time saving of 240 hours in total.
“There is no paper used [in this process] anymore.
“We’ve introduced the system in every one of the 60 wards and departments, audits have been completed in all of them and there’s been no issues.
“I think it’s a real achievement that we’ve managed to get buy in from everywhere.
“We’ll be keeping the learning process going because as people leave and new managers and staff come in, they’ll have to learn and adapt to this process.
“As the trust is going more and more digital, I think people are becoming more accepting of these digital procedures.”
“Feedback from system users has only been positive; ease of completion, going paperless, time reduction and email reminders have all been viewed very positively.
“We now have a truly paperless, cost-effective, timesaving, and time-bound process.
“I look forward to being involved in digitising other paper processes in the future and would encourage others to look at the paper heavy processes they use and consider going digital.”
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