|Implemented in this survey?|
The Safe Medication Management program is a government funded initiative designed to reduce adverse drug events throughout the health sector. The program comprises medicine reconciliation, packing drugs in unit doses, bedside verification, standardized hospital information systems and links with medicine management, standardized medication charts, and e-medication records and e-prescribing.
The Safe Medication Management program is a government funded initiative to improve patient safety by reducing adverse drug events. Although the focus of the program will initially be on prescribing, dispensing, administering and reviewing medication in public hospitals and in their interface with primary care, the program will also develop systems for safe medication management across the entire health sector.
Work streams within the program are:
A universal medicines list is also being developed as part of the program to ensure common language around the medication process. All of the work streams incorporate the training and support of staff. The program will run for four years.
The main objective is to improve patient safety by reducing the number of adverse drug events.
District Health Boards, Patients, General practice, Primary Health Organisations and other providers
|Degree of Innovation||traditional||innovative|
|Degree of Controversy||consensual||highly controversial|
|Structural or Systemic Impact||marginal||fundamental|
|Public Visibility||very low||very high|
International awareness of the incidence and cost of adverse drug events in hospitals has been increasing over the past two decades. In New Zealand, a study undertaken in 1998 indicated that 12.9% of admissions to public hospitals in New Zealand were associated with an adverse event, with around four fifths of these occurring within the hospital setting. One third of the adverse events were in medicine, most of which were drug related. This has encouraged hospital managers and policymakers to consider how these adverse events might be avoided through the implementation of quality improvement programs.
|Implemented in this survey?|
International awareness of adverse drugs events has encouraged many countries to introduce various mechanisms and procedures for reducing these adverse events. This program draws on these international experiences to develop a set of initiatives that are appropriate and relevant for the New Zealand setting.
The Safe Medication Management program is one of five projects which are being implemented in New Zealand as part of a national quality improvement program, the broad aim of which is to address quality and safety issues in public hospitals. The program was developed by the Quality Improvement Committee, a statutory committee set up under the New Zealand Public Health and Disability Act 2000. The five projects were developed in 2007 and funding was made available in 2008 for their implementation (www.qic.health.govt.nz/moh.nsf/indexcm/qic-improvementprogrammes).
The approach of the idea is described as:
renewed: Many countries have introduced initiatives for reducing adverse drug events in hospitals.
At this early stage of the program's development, all key stakeholders appear to be very supportive. All of the 21 District Health Boards - who will be primarily responsible for implementing the program - have agreed to participate in the program. As yet there appears to be no broad opposition from any groups. The project is taking a multidisciplinary approach with national representation in an attempt to ensure that the needs and interests of all of those involved in medication management are considered and to secure buy-in from all key stakeholders.
|Ministry of Health||very supportive||strongly opposed|
|District Health Boards||very supportive||strongly opposed|
|General practitioners||very supportive||strongly opposed|
|Professional organisations||very supportive||strongly opposed|
|Hospital patients||very supportive||strongly opposed|
|Ministry of Health||very strong||none|
|District Health Boards||very strong||none|
|General practitioners||very strong||none|
|Professional organisations||very strong||none|
|Hospital patients||very strong||none|
Implementation of the program is being guided by a national Steering Group together with a clinical advisory panel. The Steering Group, which comprises personnel from District Health Boards plus consumer representatives, will work with key stakeholders at the governance and senior management level. Below the Steering Group is a nine person Project Team whose role is to deliver the program. The Project Team has formed multi-disciplinary Working Groups comprising more than 60 members drawn from across the District Health Boards. They include clinicians, nurses, managers, IT personnel, pharmacists, etc. Their role will be to develop documentation, guidelines and processes to guide implementation. The program will then be introduced into selected pilot sites.
Evaluation is seen as a core part of this program and is the focus of a separate work stream. Evaluation criteria are currently being developed.
The expected outcome from this program is a measurable reduction in harm from adverse drug events. If the current level of support from key stakeholders is maintained and the program is implemented successfully within the four year period, there appears to be no reason why this objective cannot be achieved.
|Quality of Health Care Services||marginal||fundamental|
|Level of Equity||system less equitable||system more equitable|
|Cost Efficiency||very low||very high|
Research indicates that adverse events in hospitals can be very costly both in financial terms as well as in terms of the impact on patients. This suite of projects, if implemented succesfully and adopted widely, has the potential to improve the safety and quality of care for patients in hospitals and also in the community. It may also secure net savings for District Health Boards.