With the launch of the latest Open for better care campaign topic, health providers and practitioners are being asked to turn their focus to the important issue of medication safety. Elizabeth Wood, Nelson-based GP and a member of the South Island Alliance Quality and Safety Group tells us why she believes the South Island health sector needs to get behind this latest initiative.
Q: Why do you think this latest medication safety campaign is so important?
A: Through my work as a GP, I see issues with medication mishaps over and over again and especially when people with complex medical problems are having care from several providers or move from being in hospital to being at home. Also older people, especially those with frailty or multiple co-morbid conditions, are more susceptible to medicine-related errors and the frequency of adverse drug events increases with the number of medicines prescribed to an individual patient. For example the risk of an adverse drug event has been estimated at 58 percent if you are taking five medications and 82 percent if you are taking seven or more.
Q: Why is the focus on high risk medicines especially important for South Island providers?
A: New Zealand data has shown that when medication errors cause serious adverse events, serious harm or even death can occur. A large proportion of these occur within a relatively small group of high risk medicines: opioids, anticoagulants and insulin. In my experience in general practice I have seen mishaps with these medications frequently, so it makes sense to concentrate on them.
For the South Island there is an almost two-fold variation between the regions in the number of people aged over 75 prescribed eleven or more long-term medications and as the risk of medication errors has been estimated at 82 percent when you are taking seven or more medicines, this is an area where it makes sense to think carefully about all those medications and try reducing or stopping those that are less likely to be adding value.
We have seen a lot of good work on this issue in the past in the various areas, rather than as a regional approach. This campaign marks the first time the South Island can really respond in a coordinated manner, and it’s great to have that collaboration across the whole of the system. Every mishap we prevent is a significant issue for our patients so this campaign is a good reminder for providers and practitioners of the need to be more vigilant around reviewing medications, especially in the elderly. That means paying special attention to how medicines are prescribed, dispensed, supplied, stored, administered and taken.
Q: What are the Quality and Safety Service Group doing to support this latest focus?
A: The quality and safety team are supporting the sharing of ideas, learnings and project information across the South Island, to support DHBs and other providers to improve their medication safety record and identify suitable interventions. It’s about minimising repetition, sharing successes and ultimately collaboration for improved patient outcomes.
Q: What is your message to South Island health providers and staff?
A: I’d ask providers to stop and take a few minutes to think about what they might do differently in their practice that could reduce the risk of medication errors. Find even just one thing, try it once and see if it works. Then if it goes well you can include it in your usual practice, maybe audit it and you’ll be able to see real returns on reduced risk. Take note of the posters and tools – there’s some good messages and ideas there.
I think that DHBs also need to identify the most important aspect of this campaign for them, identify a small team to take responsibility and make a commitment to improving at least one aspect of medication safety across their health system.
Elizabeth Wood is a GP based in Nelson Marlborough District. She is also a member of the Quality and Safety Service Level Alliance, part of the South Island Alliance. The Open for better care medication safety campaign kicks off from 16th October 2014 for six months, with an emphasis on reducing harm from high-risk medicines. The safe use of opioids collaborative starts in October 2014 and will run for 18 months. For more information visit go to www.hqsc.govt.nz/our-programmes/medication-safety/. For more information about the Quality and Safety Service Level Alliance visit www.sialliance.health.nz.