Portsmouth Hospitals NHS Trust in peak condition with Episys

Published 5th June 2009

Summary

Portsmouth Hospitals NHS Trust has implemented Episys’ Ultimate Labelling solution to improve medicines and medical supplies labelling across the organisation.

Background

The Queen Alexandra Hospital site is currently undergoing a major redevelopment to create a modern and 'fit for purpose' hospital, due for completion by the end of 2009.

The 'emergency' department at Queen Alexandra Hospital is one of the busiest in the UK treating in excess of 100,000 patients each year. The 'Medical Assessment Unit' (MAU) and 'Surgical Assessment Unit' (SAU) provide rapid diagnostic assessment for patients admitted as emergencies. These can then be directed to the clinical areas most appropriate for their condition.

The Trust is also home to the Wessex Renal and Transplant Unit and it holds prestigious Cancer Beacon Status for the Head and Neck Cancer Services.

Challenge

Portsmouth Hospitals NHS Trust needed to introduce a labelling system to help the Trust to meet a number of different challenges. The unit at Queen Alexandra’s Hospital is a MHRA (Medicines and Healthcare products Regulatory Agency) special licensed unit. It provides aseptically prepared items which will include pre filled syringes for pain control alalgesia and for intravenous antibiotics. As the organisation is a licensed unit it means it can provide products to other Trusts throughout the country that require its services.

The Trust needed a new solution that could meet these objectives. As Robert Lucas, Principal Pharmacist, Technical Services, Portsmouth Hospitals NHS Trust, explained, “There are a lot of units and hospitals throughout the country that don’t have the staffing levels required to provide all the necessary products. We sell our services to any of our Trusts within the NHS that require our products and when we sell these services the income is helping towards the cost of our Trust and the cost of services provided.”

One of the main challenges with labelling for aseptic preparation is that the products that are made tend to be quite small, such as labels for syringes and small volume injections. Lucas said, “There is a legal requirement for the amount of information that you need to put on these labels. It tends to be quite a challenge to get all the information onto the product in a font that is readable. In addition to that we have to satisfy the requirements of the MHRA so that the system we use is actually validated properly.”

Security is also of utmost importance to the organisation. Lucas added, “We need to have a system where we know all the data is secure in the database that we use. It is also important that access to the data is controlled so that no unauthorised individuals can access it and change information. We needed to ensure that every time we print a label it prints out all the required details accurately.”

The Trust has to consider that these drugs are sometimes going directly to patients at home, alternatively they are going to a ward environment. Lucas said, “We need to make sure that the information on the labels is correct. There are lots of drugs with similar sounding names and drugs can be used in different ways, in different dosages.”

Solution

The organisation previously operated a labelling system but it didn’t have any form of reporting to let it know what labels it had produced. It also didn’t have any real form of access control or password control.

Portsmouth Hospital NHS Trust selected the Episys Ultimate Labelling solution as it provided everything required for a securer system. Lucas said, “It has a very good access control system and it reports everything that we do to the reporting log. This means that we can always go back to any of that information and check what we have done and what has been produced.”

The Trust is using the Ultimate system to label all of its aseptically prepared syringes and devices. These include; patient controlled analgesia syringes, intravenous antibiotics, intravenous feed solutions which all contain a huge amount of information on the labelling. It is also used for the cytotoxic drugs and used for its over label tablet packs.

As well as the labelling software the Trust also purchased the printers from Episys. Lucas continued, “It’s important that we don’t have any downtime with printing because a lot of work we do is an instant response. We need to make sure that the system we have got is very reliable, and also if there are any problems we need to get our system back online as soon as possible.

Benefits
The Trust saw immediate benefits following the introduction of the technology. Lucas said, “It’s enabled us to keep a check on all the production that we actually do. A good thing about Episys is the documentation that they provide. We were presented with very good IQ, OQ documentation which proved the actual system itself before we actually bought it. It also enabled us to do all our performance qualification so we could actually demonstrate to the MHRA that the system that we use is very reproducible. We recently went through an MHRA inspection of our unit and they were very happy with the system and the security it provides.”

The transfer over to the new system was simple as the Episys technology was very user friendly and training new users was straightforward. Lucas added, “Everything pops up on the screen to tell you exactly what you have to do to produce the final label.”

One of the other aspects of the printing system is the ability to produce headers and footers. Lucas said, “With the headers and footers system that Episys uses it enables us to print to the two labels that we use on batch documentation so we know we have a split between the print of one batch to the print of another batch. By using that information on the batch sheet we know who’s printed the label and when they printed it.”

The Trust has also purchased Episys’ Ultimate Worksheet module. Lucas said, “Most of the production units within the NHS use Microsoft Word to produce all our batch documentation. Previously, we produced authorised master documents which are stored as hard copy on file and when we need to make a batch we photocopied the word document. From there we will have to populate that document with variable information such as; batch number, expiry date etc. However, with the Worksheet module, at the time we populate the worksheet with this information it prepares the labels for us at the same time. This will avoid a lot of transcription by operators and not only does this save time but more importantly it should dramatically reduce errors as very little transcription is required.”

Also, when using Word documents it’s difficult for the Trust to secure that document within a system. Lucas added, “Different people have access to the same computers as it’s easy to alter a document. By using Episys we can actually lockdown that format within worksheets, so there’s only certain people that have access to a particular design. We’re now happy that no one can inadvertently change a worksheet which could have critical consequences.”

The Trust has a range of approximately 300 to 400 different products that are supplied to customers. Lucas said, “We need to make sure we are producing these labels with the correct codes and reference codes so they go to the correct customer. There are lots of labels that are very similar and many of the drugs have similar names. We must be able to differentiate between the product label that one customer wants compared to a label that another customer wants, so it’s important we control the process.”

The Trust has also purchased the Ultimate Approvals module to speed up the control of their new product business. The module enables the Trust to issue customers with a new label electronically and obtain feedback much quicker than having to send them a hard copy of the label either by post or fax

The future

Lucas said, “We have made a very good decision in going to Episys. The solution has met all our requirements, it’s very secure, safe and reliable and we know when we produce a label for a customer that it is exactly what they require.”

In the future, the Trust is going to be looking at colour labelling. Lucas concluded, “There is a huge drive to differentiate products and a lot of the products we make have similar sounding names. We are looking at introducing some form of colour coding so people can differentiate between products strength to reduce confusion at ward and patient level.”