Safely managing medications in community-based programs

To ensure patients receive their medications safely while participating in our community-based life skills and recreational programs, Holland Bloorview Kids Rehabilitation Hospital has introduced a new medication management process.

The process redesign followed a medication incident in one of our programs and was created by an interdisciplinary team that included client and family advisors. The new process has led to the standardization of how medications are stored and administered. Previously, each program had its own method of managing medications.

“This was an opportunity for us to apply best practices for medication management in very unique environments,” said Nathan Ho, manager of the pharmacy department, who was part of the team that developed the standardized medication management process. “It was important to us to enhance patient safety beyond the four walls of the hospital.”

The new process includes a standardized medication intake form, photo identification on the medication records, the introduction of wrist bands for program participants, flagging potential issues if clients have similar names and checking two pieces of client identification before administering medication.

New medication storage containers include fanny packs, temperature-controlled backpacks and mobile medication carts.

“Employees can’t strap a fridge to their backs when at camp, so we needed to identify the kind of dedicated storage containers that could be used in these programs, but that would maintain the integrity, security and safety of the medications required,” said Nathan.

To ensure that all safety measures are kept in place, the hospital implemented regular education sessions for staff, paired a nurse with each program to oversee medication intake on the first day of all programs and routinely audits all programs.

Natalie Timbrell, a life skills facilitator in the independence program for youth with disabilities, said she feels supported by hospital professionals who are experts in patient safety. The education sessions provide her and her colleagues with information about medication risks, proper storage, security and privacy, among other issues, she added.

“A number of participants in the independence program have a goal to become more independent with respect to managing their medications, including learning about their medications, when to take them and how to store them. When program staff are well supported and trained, we can then help the youth in our programs learn to take accountability for their medications and health,” said Timbrell.

“We want to facilitate experiential learning for our clients and preserve the nature of these programs, while ensuring safe practices and high quality of care,” said C.J. Curran, operations manager in the participation and inclusion portfolio.

The improvement process was a collaboration between participation and inclusion, quality and safety, pharmacy and, importantly, family representatives. The group also consulted with members of the hospital’s Youth Advisory Council.

“Families and youths are experts in care and it was critical that they were at the table. They shared their experiences and recommendations,” said Nick Joachimides, manager of patient safety.

C.J. noted that that the success of the new medication management processes is in large part due to exceptional staff. “They were open to the new processes and fully committed to enhancing patient safety while mitigating risk.”

The new medication management process is so innovative that Accreditation Canada, an organization that leads voluntary, peer reviews of health-care organizations, recognized it as a leading practice in health care across Canada.

“To create a sustainable medication management program says a lot about Holland Bloorview and the strong support from our leadership to move the program forward,” said Nick. “The hospital has a strong desire to do the best thing possible for our clients and to optimize their experience in these programs while reducing the potential for harm.”

By Lydia Hanson, Senior Communications Associate, Holland Bloorview Kids Rehabilitation Hospital

Article appeared in the October 2014 edition of Hospital News.