This letter is an output from the Electronic Prescribing & Medicines Administration (EPMA) application, which will usually contain a variety of important clinical information, details of medicines prescribed and those discontinued.
Traditionally, supplementary documentation that included anticoagulant (e.g Warfarin) doses that were administered in Trust and those to be taken post discharge, would be scanned and emailed to patient GP’s, this document may have also included patient INR levels.In order for these anticoagulation prescriptions to be sent to the GP, clinical staff must engage with the anticoagulant teams in order to notify of any warfarin patients being discharged.
Working in partnership the Trust teams and the EPMA provider was able to include on the discharge summary;
• Patients INR at discharge• Date of next test • Clinical indication,
• If New - Target INR
• Length of treatment
• Date and Dose of up to 5 doses post discharge
Also included on the discharge summary; up to the last 5 administered, including
• Time and date of administration • INR,
• Dose Given
• Next Test Due
This has significantly reduced the risk of GP’s not having correct or accurate information associated with missing anticoagulant documentation or those related to poor handwriting.
Internally, it has negated the need for clinical teams to contact anticoagulation team to inform of a patients discharge, focusing the team’s attention to clinical rather than administrative tasks. The anticoagulant teams are able to run reports and filter for Warfarin patients, check administer and discharge doses well in advance of any manual notification.
The letter automatically includes the discharge prescription and administered doses without user interaction, streamlining manual process, removing ineligible and possibly transcribed information issues.
Ultimately it has massively improved communication and eliminated long standing entries from the Trust risk register.