Journal
INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE
Volume 30, Issue 5, Pages 396-407Publisher
OXFORD UNIV PRESS
DOI: 10.1093/intqhc/mzy035
Keywords
Self-administration; quality improvement; medicines; hospital; patient involvement
Funding
- Imperial College Healthcare Charity [GG1516/100000, SG1617/03]
- National Institute for Health Research (NIHR) Imperial Patient Safety Translational Research Centre
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Quality problem or issue: A patient survey found significantly fewer patients reported they had self-administered their medicines while in hospital (20% of 100 patients) than reported that they would like to (44% of 100). We aimed to make self-administration more easily available to patients who wanted it. Initial assessment: We conducted a failure, modes and effects analysis, collected baseline data on four wards and carried out observations. Choice of solution: Our initial assessment suggested that the main areas we should focus on were raising patient awareness of self-administration, changing the patient assessment process and creating a storage solution for medicines being self-administered. We developed new patient information leaflets and posters and a doctor's assessment form using Plan-Do-Study-Act cycles. We developed initial designs for a storage solution. Implementation: We piloted the new materials on three wards; the fourth withdrew due to staff shortages. Evaluation: Following collection of baseline data, we continued to collect weekly data. We found that the proportion of patients who wished to self-administer who reported that they were able to do so, significantly increased from 41% (of 155 patients) to 66% (of 118 patients) during the study, despite a period when the hospital was over capacity. Lessons learned: Raising and maintaining healthcare professionals' awareness of self-administration can greatly increase the proportion of patients who wish to self-administer who actually do so. Healthcare professionals prefer multi-disciplinary input into the assessment process.
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