Assessing a hospital medication system for patient safety: Findings and lessons learnt from trialling an Australian modified tool at Waitemata District Health Board

Abstract

Abstract Aim To undertake a review of Waitemata District Health Board’s (WDHB) hospital medication system for patient safety assessment and improvement purposes. Method A multidisciplinary group rated current WDHB hospital medication systems against the Medication Safety Self-Assessment for Australian Hospitals (MSSA®-AH) criterion of 247 aspirational practices using a five point scale (“no” to “fully implemented”). Items with a lesser extent of implementation represented practice gaps. The MSSA®-AH database and weighted adjustment scoring system generated an overall hospital score. Results Of the maximum possible score that could be obtained had all MSSA®-AH practices been implemented, WDHB scored 63% and this was comparable to other demographically similar hospitals in Australia. Lowest scoring practices needing improvement related to staffing. Conflict resolution was a previously unidentified practice gap. Previously identified gaps, such as those relating to electronic medication systems suggested ongoing implementation was required. Conclusion This was the first documented use of the MSSA®-AH’s in a New Zealand hospital setting and helped WDHB identify areas in need of further improvement. The unique generation of a percentage score helped simplify understanding for non-technical stakeholders. Future repeated assessments would help WDHB track progress. Implicit benefits, such as stakeholder engagement, were observed. The MSSA®-AH may be useful in other hospital settings. METHODS: A multidisciplinary group rated current WDHB hospital medication systems against the Medication Safety Self-Assessment for Australian Hospitals (MSSA®-AH) criterion of 247 aspirational practices using a five point scale (“no” to “fully implemented”). Items with a lesser extent of implementation represented practice gaps. The MSSA®-AH database and weighted adjustment scoring system generated an overall hospital score. RESULTS: Of the maximum possible score that could be obtained had all MSSA®-AH practices been implemented, WDHB scored 63% and this was comparable to other demographically similar hospitals in Australia. Lowest scoring practices needing improvement related to staffing. Conflict resolution was a previously unidentified practice gap. Previously identified gaps, such as those relating to electronic medication systems suggested ongoing implementation was required. CONCLUSION: This was the first documented use of the MSSA®-AH’s in a New Zealand hospital setting and helped WDHB identify areas in need of further improvement. The unique generation of a percentage score helped simplify understanding for non-technical stakeholders. Future repeated assessments would help WDHB track progress. Implicit benefits, such as stakeholder engagement, were observed. The MSSA®-AH may be useful in other hospital settings.