Student Dissertation

Agency : Medication turnaround time, Indent, Hospital Information System

Objective : Not Available

Background : Medication turnaround time is defined as the interval from the time a medication order is written (manually or electronically) to the time the medication was administered. Monitoring medication turnaround time in inpatient settings allows organizations to measure the impact of their health IT application on the increased efficiency of patient care. Rationale: The common complaints by the patient party as registered by the service excellence department in SRS Sunflag Hospital, stated that the patient receives first dose of medicine many hours after the admission. The average Medication Turnaround Time as recorded by the administration team in month of January was around 4.5 hours i.e.: 270 minutes whereas the policy of the hospital says that first dose of medication should be given no later than 2 hours i.e.: 120 minutes.

Methodology : Study Design- Pre-Test & Post Test Observational study Sample- 210 New admitted patients to the Wards of Sunflag Hospital in Pre Test Phase and 180 New admitted patients to the Ward In Post Test Phase Data Collection- Pre intervention and Post intervention data has been collected for 210 patients and 180 patients respectively, admitted to the general ward for duration of 8 days each. It is based on time observation of critical events, HMIS system of the hospital and patient records. The data collected were under following heads: Date of admission, Time of Admission (T1), First indent time- Time at which the Nursing staff ordered the indent of Cannula, Germicidal Solution and Dressing (T2), Prescription time – first time at which the prescription by the Consultant was available in patient records. (T3), Order by Resident on Duty – time at which the Duty Doctor has written the prescription on Physician Order Sheet (T4), Treatment indent time – Time at which the Nursing staff made the ordered the indent of Medicines(T5), Medicine received in Ward – (T6), Treatment Administration Time – (T7).

Findings : There was a decrease in time at all levels of delay in post test phase i.e. at level 1 (Time of Admission to Treatment indent Time -T1 to T5), level 2 (Indent Time to Medicine received in Ward -T5 to T6) and level 3 (Medicine received in ward to Medicine given to patient -T6 to T7). The change in median observed is 83 minutes, 5 minutes and 7 minutes respectively. First Medication Turnaround Time in minutes i.e. Time of admission to Time medicine has been given to the patient (T1 to T7). In pretest phase the median is 260.5 minutes whereas in post test phase the median is 143 minutes. There is a decrease of 117.5 minutes in post test phase.

Recommendations : The intervention of MTAT Register for new admitted patients has increased the accountability of all the persons involved in the process i.e. Nurse, Duty Doctor and GDA. Although Consultant and Pharmacy are still not accountable for the process but recording of activities puts a pressure on the system at all levels to fasten up the process. The regularity in maintaining the MTAT Register has significantly decreased the MTAT by 117.5 minutes