Aim To determine the efficiency of dispensing paediatric discharges at dispensary vs ward level.

Method A data collection form was designed for use during a two-phase audit. During the first week of data collection, the turnaround time of dispensing discharges in the dispensary was collected. In the second week, the turnaround time of dispensing discharges at ward level on the paediatric ward was recorded.

The dispensary standard of a 60 min turnaround for medium priority discharges¹ was used for both weeks. Medical, surgical and ENT prescriptions were all included in the audit.

Results Information relating to 23 discharges was collected during week one at dispensary level. In week 2, 21 discharges were assessed.

When assessing the minimum and maximum time taken from when a patient was informed of their discharge to medications being given, there was a reduction of 98 min when completed at ward level for minimum time and 75 min for the maximum time.

The average turnaround time for dispensing prescriptions was 94 min at dispensary level and 26 min at ward level. Only 57% of discharges completed in the dispensary met the standard turnaround time of 60 min compared to 100% completed at ward level. Discharge prescription turnaround time was decreased by 72% when completed at ward level.

In total sixteen discharge steps were identified using the traditional dispensary based method for discharges. These ranged from the patient being told they can go home on the ward round to the prescription being written and sent to pharmacy, and finally returned to the ward for transfer to the patient.

The process of dispensing discharges at ward level enabled a reduction of 50% of the sixteen steps, subsequently expediting the discharge process.

Conclusion When discharges were completed at ward level standards were met 100% of the time and a reduction in eight discharge steps was accomplished. Thus highlighting that a ward level dispensing service is necessary on the paediatric ward in this District General Hospital.

Reference

1. Wallace K. Prescription Tracker System (PTS). Patient services District General Hospital2014.