In a busy hospital setting, innovative technology makes medication rounds safer and more efficient, helping NHS nurses save 87 minutes each, per day, in ground-breaking trial.
PillTime uses the latest robotic technology and artificial intelligence to dispense medication. When implemented in Salford Royal hospital, the PillTime method saved NHS nurses an average of 87 minutes a day by making medication rounds more efficient. Key benefits included safer administration, better patient care and a calmer working environment for nurses.
As pressure mounts, nurses are under a huge deal of pressure to maintain standards of patient care. With nurse resources stretched and workloads soaring, the Royal College of Nursing expresses concern about safe staffing levels within the profession.
At the RCN Annual Conference, Dame Donna Kinnair closed her address by stating that the goodwill of nurses is currently being abused.1 NHS nurses are crying out for more support. This has been a growing concern over the past decade, which comes to a head as unfilled nurse vacancies reach 40,000. Think tanks warn that this could grow as high as 100,000 in ten years’ time.2
Better support required for NHS nurses – the role of medication management
Nurse shortages reach alarming highs as the Health Foundation reports that more nurses than ever are leaving the profession due to poor work-life balance. Effective and meaningful solutions must be put in place as soon as possible, to improve nurse retention and job satisfaction. These solutions need to be nurse-led and should support nurses both practically and emotionally.
Nurses spend a great deal of time administering medication to patients. With up to four rounds per day and dozens of patients to care for, rounds can become unmanageable and potentially un-safe. A daunting task for new staff in particular, nurse Shannon Leigh of SRFT tells us that rounds often take nurses up to two hours each when they first qualify.
Improving the accuracy and fluency of these rounds could dramatically improve nurse job satisfaction and patient care, as PillTime found in a revolutionary medication trial with Salford Royal Foundation Trust.
The PillTime method
PillTime was founded in 2016 by award-winning Pharmacist Paul Mayberry, who sought a simpler solution to medication management. What he came up with was organised medication pouches that are created by robots and checked by optical recognition technology.
This conception was based on simplicity. Mayberry wanted to create a more streamlined process that made medication simpler. No fuss, no hassle and no confusion. With twenty-five years of industry knowledge under his belt, he knew that the best way to achieve this was through technology.
PillTime harnesses the latest robotic technology to dispense medication into clearly labelled, dose-specific pouches. The robots are programmed to follow the prescription instructions, as advised by the patient’s doctor. These tailored pouches are dispensed on a roll, in the order they need to be taken, so it’s easy to see exactly what needs to be taken and when.
Improving medication management on-ward
Six months ago, PillTime took on a new venture to uncover the benefits of using PillTime technology in NHS hospitals. Salford Royal Foundation Trust is one of the most digitally mature hospitals in the country. A hub of healthcare innovation, Salford Royal proved the perfect environment to house a ground-breaking dispensing trial. Partnered with PillTime, they implemented robotic pouch dispensing on ward to improve medication management and ease nurse workload. The results were staggering.
The PillTime method of administering medication saved each nurse a staggering 87 minutes a day, on average. When nurses began using PillTime pouches during rounds, efficiencies soared, job satisfaction increased, and patient safety improved. With PillTime pouches, nursing staff don’t need to worry about sorting doses and organising many boxes of medication. Everything a patient requires for one dose is in a single, robotically dispensed pouch. The patients’ details are displayed clearly, to improve the speed and accuracy of identity checks. When organising a lot of medication, it can be easy to make mistakes. However, modern dispensing technology removes the risk of human error to ensure that medication is accurate.
Reducing pressure on nursing staff
After pouches leave the robots, they are passed through an optical checker. This is an intelligent piece of technology that scans every pouch to ensure each pill is correct. The checker takes a photo of every pouch, that can be stored as part of a patient record. Pharmacists then refer to the optical checker, as necessary. This accuracy checking record provides peace of mind to nurses that doses are correct and patient safety bolstered.
Whilst accountability is essential in healthcare, Dame Kinnair expresses her concern that nurses are shouldering all responsibility for patient safety, which could exacerbate workplace stress and thus lead to errors in medication and care. Kinnair said: “There is nothing worse for a healthcare professional than knowing you’ve made a mistake or weren’t able to give the best possible care.”1
Medication management is complex and errors at every stage of the prescription process can lead to poor patient outcomes. A 2018 report commissioned by the Department of Health and Social Care found that 237 million medication errors occur every year in England, with 28% of these considered clinically significant.3 Errors are both dangerous and demotivating for staff. PillTime technology helps reduce these errors, to improve patient safety and reduce the burden on nurses.
The PillTime method of medication dispensing takes the pressure off nurses to organise doses. Each pouch is clearly labelled with a full dose description, that includes the patient’s name, the date and time of dose and a description of each pill inside the pouch. With such tailored descriptions and full visibility over every dose, administration is safer and swifter.
Salford Royal nurses flagged this as a key benefit of the trial. Nurse Earl Thomas reports: “The descriptions on the pouches for all medication makes for simpler and faster administration. This also increases patient safety when cross referencing with our EPR system allowing for safer administration.”
Nurse job satisfaction and work-life balance is a real concern. Anita Charlesworth, the Health Foundation’s Director of Research and Economics notes: “Retention rates have worsened in recent years, and almost three times as many people are citing work-life balance as a reason for leaving the NHS at the beginning of 2018/19 than in 2011/12.”4 This data, coupled with the fact that 1 in 9 nursing posts are currently unfilled, means that the profession requires impactful change.2
PillTime pouches create a calmer working environment and reduce workplace stress. Nurse Nadine Keates was part of the piloting team, and tells us, “The PillTime pouches have made for more efficient drug rounds and a calmer and more relaxed atmosphere on the ward.”
The project has facilitated a more desirable work environment for nurses. As well as having a more relaxed working day, the timesaving means that nurses are more likely to leave work on time, thus giving them a better chance of achieving work-life balance.
The NHS Long Term Plan outlines a new model for patient-focused care, that considers ‘what matters to someone’.5 PillTime knows that patients are more likely to take their medication properly if it fits around their lifestyle. Having medication pre-sorted and delivered to a patient’s door eliminates the hassle that’s associated with multiple prescriptions. Plus, with one just one pouch for every dose, patients can take a pouch out for the day, without having to carry around heavy boxes.
Due to the time-saving efficiencies in Salford Royal, nurses were able to spend more time with patients, to improve their education about medication adherence. Nurse Earl Thomas notes: “The time saving has allowed us to provide advice to patients on medication usage and also more personal engagement with them.” This means that not only is medication management efficient in hospital but continues to improve when the patient is discharged. This patient education is essential in combatting non-adherence outside of hospital.
How to get started with PillTime
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Please note, this article will appear in issue 10 of Health Europa Quarterly, which will be available to read in July 2019.