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Regional Innovation Fund 2010/11 Project: PC 10001

The Patient Medicine and Communication Bag

 

NHS Derby City

 

This project will work alongside the East Midlands Adoption Campaign: Patient Medicine Bag and give patients a Patient Medicine Bag containing medication plus personal information. This will provide urgent care services with accurate information when the patient is unable to provide this information themselves.  This will save time, enable a medicines review to take place, prevent unnecessary admissions, avoid discharge delays and stop unnecessary repeat prescriptions.

 

Urgent care services have limited information when they attend patients out of normal hours.  This is compounded when the patient themselves either has a communication difficulty due to memory loss or a learning difficulty.  Previous research by Mary Green identified that time and money is wasted because patients do not bring their current prescription medicines on admission to hospital.  This results in medication errors and litigation, extra work in pharmacies and delays in discharge, as well as unnecessary harm and distress to patients.

Lack of information is one of the factors leading to avoidable urgent care and admission to hospital, particularly where the patient has a cognitive deficit and lives alone.  The provision of information will enable urgent care services to consider non-acute care options.  Where an admission occurs, accurate information will enable early targeted care and discharge planning.

The adoption of the Patient Medicine Bag was recommended by the National Patient Safety Agency (NPSA) in 2007 but this is still to be achieved across the entire East Midlands.

 

Patients with cognitive impairment will be given a Patient Medicine Bag containing medication + personal information.  This will provide urgent care services with accurate and timely information, when the patient is unable to provide this information themselves.  This will save time, facilitate a medicines review and stop unnecessary repeat prescriptions; help prevent unnecessary admissions and avoid discharge delays if an acute admission is required.

This proposal builds on the NHS East Midlands Patient Medicine Bag project and will act as a pilot, with a view to listen to the experiences of staff, patients and carers to refine the communication tool and cascade the learning.  It will particularly support people unable to provide information themselves at a time of crisis i.e. those with memory or cognitive impairment.  This is a multi-organisational project supported by Derby Hospitals NHS Foundation Trust, Derbyshire Healthcare NHS Foundation Trust, East Midlands Ambulance Service (EMAS), Derby Social Services, NHS Derby City Provider Services and the Alzheimer’s Society.

·         To ensure that the pilot can be delivered by March 2011, the Green Bag will only be issued to patients and service users in Derby City and Southern Derbyshire who:

·         Have cognitive impairment AND receive intermediate care.

·         Are on a Community Matron’s caseload. 

·         Receive active support from Derbyshire Healthcare NHS Foundation Trust

·         Receive Social Care

·         Attend Dementia Cafés or other peer support services run by the Alzheimer’s Society or other voluntary agencies

Are resident in one of the identified care homes

 

·         Readily available information in an emergency

·         Personal preferences made known to care providers

·         Person focussed care due to improved communications

·         Provision of relative\carer information enables providers to inform them in an emergency in a timely way.

·         Indication of whereabouts of advanced directive

·         Reduction in the length of stay in hospital

·         Reduction in the need to repeat information collection.

·         Safer medical treatment

·         Reduction in medication errors

 

·         Staff will be able to provide person-centred, high quality care though better communication

·         An increased sense of job satisfaction

·         Reduced litigation and complaint. 

Staff will be able support continuity of care across all sectors.

 

This project will deliver non-cash releasing benefits with the potential to deliver future cash release.  The York Health Economics Report 2002 indicates that savings are unknown but that the Patient Medicine Bag could save the NHS £15m per annum by reducing medication errors and consequent litigation costs and unnecessary repeat prescriptions. 

In addition it could reduce unnecessary acute admissions and lengths of stay by 10%. This will be quantified via the project in the light of increased activity in the community e.g. in Intermediate Care.

The project will impact up to 5,000 people across Derby City and Southern Derbyshire.

PMB RIF Project - Ciara And Dee

Updates on The Patient medicine Bag...

Local media...

The Patient Medicine Bag has been reported on in local media. There is a short piece on This is Derbyshire website - Click HERE to read the piece.

Also...

Including 'This is Me' document in The Patient Medicine Bag

This Is Me - Communication Tool

"This Is Me" is a simple and practical two page document that provides a 'snapshot' of a person with dementia, giving information about them as an individual, such as needs, preferences, likes, dislikes and interests. While designed for patients living with dementia, it can also be used for many other conditions.

In Derby, NHS Derby City is leading a project to include it in Green Medicine Bags meaning that paramedics will be able to see if the patient has dementia. This will then help the paramedic to reduce distress for the patient and their carer and ultimately reduce the number of cases where a person needs to go to hospital. If the patient does go to hospital, the document can also help clinical staff to treat each person as an individual and prevent issues such as malnutrition and dehydration.

Alzheimer's Society is excited about this partnership work with NHS Derby City and would like to explore the possibility of "This Is Me" being made available for people with 'Green Medicine Bags' across the region if the Derby scheme is a success.

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Contact the Innovator

Ciara Scarff, Derby and Derbyshire Health and Social Care Community

ciara.scarff@derbyshire.gov.uk

 

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Documents to Download 

East Midlands EXPO Poster

See the project featured in the East Midlands Regional Innovation Fund Projects Brochure on Page 46