Herefordshire and Worcestershire Health and Care NHS Trust delivers ePMA project in record time

Herefordshire and Worcestershire Health and Care NHS Trust has implemented the Better Meds electronic prescribing and medicines administration (ePMA) solution across the pilot ward in just ten weeks, despite an earlier, unrelated, setback due to a significant EPR and PAS outage.

The implementation at the community and mental health trust took place between mid-March and May this year and is already helping to improve patient safety, enable efficient workflows for clinicians and reduce paper.

During implementation, the trust first opted to go live in a six-bed pilot ward that provides specialised end-of-life care. This approach allowed for rigorous testing of prescribing regimes and the software's capabilities. Quickly building on this success, the project extended to a 28-bed rehabilitation ward, focusing on different sets of requirements. For example, the ability to transcribe complex paper drug charts into the software.

As a result of the pilot's success, the trust has now decided to bring forward its implementation plan for all its seven community hospitals, with an ambition to be complete by October 2023.
Benefits of the implementation are already being realised, including significant time savings, improved patient safety due to the complex nature of drug administration and prescribing, and reduced paper use across wards.

The solution also supports new models of care by enabling clinicians to log-in to the system wherever they are, discuss with an on-site nurse and make decisions on prescriptions and care plans remotely. This is reducing the need for on-call GPs and consultants, freeing up clinicians' time and ultimately providing faster, safer care for patients.

The flexibility of the OpenEHR-based Better Meds ePMA solution ensures that it can be configured effectively to meet the needs of the clinical teams and the patients they care for. For example, the trust opted to create order sets in the solution to support Patient Group Directives and Simple Meds. Going forward, these will be expanded to include Mental Health medication regimes. The trust also opted to run Better Meds as a separate system from the trust EPR, to further streamline processes.

During implementation, Better also provided advice on clinical safety and supported the trust with the development of order sets for palliative care wards, where patients often need complex prescribing regimes.

A pivotal factor contributing to the project's success was the buy-in at all levels, from the Board to doctors, pharmacists, nurses and support staff, as well as the Better team.

The project team consisted of representatives from across the trust’s multidisciplinary teams, including the Medical Director, Clinical Director of Palliative Care, Chief Information Officer, Pharmacy Director, Nursing Director, IT Project Manager and input from the Sisters and Matrons from the community hospitals.  

Ahead of and during the implementation, Better supported the trust project team to train a core team of ‘super-users’, and were visible on-site throughout to provide support.
Engagement sessions and roadshows were also held prior to implementation, allowing staff to raise queries and understand the impact of the roll-out. Comprehensive mandatory online training was then provided to all staff members, resulting in an impressive 90% completion rate.  

Ian Douglas, EPMA Clinical Engagement Lead at Herefordshire and Worcestershire Health and Care NHS Trust said: “The Better team took the time to understand our requirements and what we were trying to achieve at the trust. Having the Better team available when we needed them was incredibly reassuring. They’ve been a constant source of support, offering guidance and expertise whenever needed. What sets them apart is their commitment to transparency and open communication.”

The combined effect of having behind-the-scenes support and visible presence meant that all staff felt confident in the new ePMA systems and could see the benefits it would bring.

Fazila Tagari, Project Manager at Herefordshire and Worcestershire Health and Care NHS Trust admitted that some staff initially felt apprehensive by the shift from paper-based processes to a digital ePMA system, however, they have since had fantastic feedback. “Some nurses had been working using paper for 20-30 years and so it was a big change to a new system . We found that once they had seen how Better Meds works, they were very happy with it.”

Implementation of the ePMA system marks a significant step in the trust's digital transformation journey.

Stefan Siekierski, Delivery Director at Better said: "The rapid implementation at Herefordshire and Worcestershire is a true testament to the hard work and dedication of the project team, ultimately leading to improved patient care and streamlined workflows. This is the tenth successful implementation of Better Meds, which is evidence of the strength of the solution and the effort at which our teams go to deliver for our customers. We believe in advancing the digital maturity of the sector to enhance patient care and experience and will look for opportunities to help other trusts at outreach events to benefit the broader healthcare community."