Better Meds
We had the opportunity to speak with Lex Moon, an ePMA Clinical Lead and Advanced Specialist Perinatal Pharmacist Prescriber at Oxford Health NHS Foundation Trust, regarding the successful implementation of the Better Meds system across all mental health inpatient wards in the Trust, which Lex attentively documented on her LinkedIn profile.
Congratulations, Lex! How do you feel after successfully completing this extensive project? I must admit, we eagerly awaited your LinkedIn updates as you documented the progress every few days and kept us in the loop.
I, as well as the rest of the team, are feeling exhausted but incredibly proud of everything we have been able to achieve. I must admit, it was a bit surreal when the last ward went live last Tuesday. As we had been talking about this moment for so long, I couldn't quite believe it had finally happened. It has been a combination of a lot of hours, a lot of sacrifice and a huge passion for the project from the whole team which has helped us to achieve everything we have in a relatively short time frame.
My LinkedIn posts were a way of marking our achievements, sharing them with others and acting as a countdown for the remaining wards. I did not realise the impact they were having.
Now, the project is complete. Do you anticipate a more relaxed and joyful holiday season?
Yes, a couple of weeks ago, the whole team got together for a Christmas party/rollout completion celebration. It was great to see everyone having the opportunity to look back on what they have achieved and to celebrate that success.
I have also encouraged the team to take some time off over the Christmas period and to really take the opportunity to switch off and recharge. I am on-call for ePMA over the Christmas period alongside our programme manager, Nicci Wilson, but this will not feel as intense as the rollout has already been done. We don't get a huge number of queries on-call as the wards have taken to the system so well.
If I understood correctly, you initiated the ePMA implementation a year ago but encountered setbacks that required restarting. Can you elaborate on the lessons learned from the initial attempt?
Yes, we initially took our pilot ward live in July 2022; the pilot was going really well, with very few issues being raised. Then, the cyber-attack on Advanced in August 2022 led to our PAS system being unusable, meaning we were unable to feed patient data into Better Meds, and subsequently, we made the difficult decision to stop the pilot at the end of August 2022 and revert to paper charts in the interest of patient safety. This was the right decision, as we ended up with no PAS system in the Trust from August 2022 until January 2023.
The initial rollout of the pilot showed us the importance of good preparation; we believe the lack of concerns raised with the ePMA system during the first pilot was due to the intense preparation that we put in beforehand. It also made us aware that these once in a blue moon issues that may occur do need planning for as, although rare, they are not impossible.
What elements and processes were repurposed from the first iteration?
To be honest, almost all the processes were repurposed. Our processes were working well, and the reason for the downtime was outside of our control. We kept the plan very similar for the second pilot. We did, however, take the downtime to work on version updates and other updates in the system so that we were not wasting time waiting on our PAS system.
One slight change was the use of manual forms for entering patients onto Better Meds to allow our pilot and fast follower ward to go live without having integration being in place between Better Meds and our new PAS system.
I ask this because the progress made has been remarkable. What would you say is the recipe for such a successful and rapid rollout?
In the main, there are two things: teamwork and preparation. I cannot state enough how much good preparation, prior to even attempting to pilot the system, can make a massive difference in the outcomes as well as the speed at which you can roll the system out. Most importantly, our team has pulled together and worked tirelessly to achieve this goal; it has not been easy and has involved so much dedication and sacrifice from the team, but each person has had a vital role to play.
Also, constant communication with the wards about the plan, where they were regarding training and what to expect during go live weeks. We would normally meet with a ward 6-8 weeks before they were due to go live to ensure ePMA was brought to their attention. We would then agree on the rollout plan for the ward, including training and timings.
Certainly, you weren't working on this project alone. You mentioned having a team alongside you. Who were the key contributors to this success?
I certainly didn't work alone on this project. I have been lucky enough to work with an amazing team who have all worked just as hard as me to make this project a success. Alongside me, our current team consists of Nicci Wilson (Programme Manager), Adam Hamilton (Lead ePMA Pharmacy Technician), Elliott Dempsey (ePMA Pharmacy Technician), Melissa Townsend (ePMA Pharmacy Technician), Beatriz Estevan (ePMA project support officer), Rhoda Agbamuche (Clinical Systems Trainer), and Jim Palmer (Senior EHR Clinical Facilitator).
There were also others involved earlier in the project who have either changed roles or left the Trust since the project started rolling out, as well as a vast array of staff within the IT, CAST, integration and many other teams who were also responsible for helping the project get to where it is now.
Speaking of people, how have the new users responded to the Better Meds?
Incredibly well. There is always going to be an element of nervousness amongst staff when a new system or way of working is introduced. However, what we are finding is that once the staff have been able to use the live system with the support of the ePMA team during go live, the nerves are rapidly disappearing, and we are receiving a lot of positive feedback about Better Meds. We are also getting numerous people volunteering on the wards to be ePMA champions, which is brilliant as it shows staff are really getting behind Better Meds.
With the new year approaching, could you share insights into the next steps for ePMA within the Trust? Are there plans for integrations with other systems and solutions?
There are a few plans in place for the new year. In terms of Better Meds, we are planning to roll out the Mental Health Act functionality (T2/T3 forms) and upgrade the system to version 3.14, which in turn will allow us to roll out to community mental health teams.
In terms of integration, we are hoping to complete our integration with Ascribe (our Trust pharmacy dispensing system), which will help to reduce the workload for pharmacies and allow them to truly start feeling the full benefits of ePMA. It is going to be another busy year, but after the Christmas break, we will hopefully be refreshed and ready to go with our next phase of rollout.