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In the pursuit of safer and more efficient medication administration practices, healthcare institutions around the world are embracing innovative solutions.
The journey of implementing closed-loop medication administration, particularly through single-unit dosing, holds promise for transforming patient care.
“A national drive and commitment to embracing technology that delivers tangible benefits for all patients are essential”
Recently, a team from University Hospitals of Leicester NHS Trust (UHL) embarked on a knowledge-sharing expedition to Cleveland Clinic London, shedding light on the transformative power of collaboration and shared learning in healthcare.
Future Nurse facilitated this visit as an opportunity for UHL leaders to see a fully closed loop medicines administration in use across a whole organisation and for both sites to share learning and identify opportunities for collaboration.
Despite the contrasting nature of the institutions involved – one a private, digitally advanced facility, and the other a large NHS trust made up of multiple – the shared commitment to administering medication safely underscores a universal imperative in healthcare.
Our visit to Cleveland Clinic London provided invaluable insights into the potential of fully closed-loop medication administration.
Witnessing their remarkable success with medication safety – served as a testament to the transformative power of innovation and collaboration.
Sonia Kelly, chief nursing infiormation officer (CNIO) at Cleveland Clinic London, aptly captured the spirit of collaboration, emphasizing: “Our mantra of ‘patients first’ is about more than just healthcare.
“It’s about fostering a healthier, more sustainable, and more educated community of clinicians for every patient in the UK to benefit from.”
Single-unit dosing represents a significant shift in medication administration, automating much of the workflow and offering tangible benefits in safety and efficiency.
According to recent studies, medication errors in the NHS are estimated to affect approximately 237 million medication doses annually, resulting in significant patient harm and avoidable costs.
The evidence shows that the adoption of closed-loop systems with single-unit dosing, can reduce medication error rates by up to 87%, significantly enhancing patient safety and outcomes.
However, the journey towards fully closed-loop medication administration is not without its challenges. Implementing such systems requires substantial financial investment, technological infrastructure, and staff training.
The initial costs associated with procuring IT hardware and software, alongside the integration of closed-loop workflows into existing processes, can pose significant barriers for healthcare institutions, particularly those operating within constrained budgets.
Moreover, the transition to single-unit dosing will necessitate changes in workflow and staff responsibilities, requiring comprehensive training and buy-in from frontline caregivers.
Resistance to change and concerns regarding workflow disruptions can further complicate the implementation process, highlighting the importance of effective change management strategies and stakeholder engagement.
While many NHS organizations have made strides in medication safety, none have implemented single-unit dosing, essential for achieving a closed-loop system where medications can be tracked seamlessly from arrival in the supplies bay to ingestion by the patient.
This requires significant investment and multi-agency working to remove the barriers that currently exist.
UHL is the first NHS trusts to embark on a journey to ward-based, unit-dose dispensing with a fully closed loop system in an admirable effort to improve medication safety.
Currently, live in three areas with an ambition to scale this across the trust. The UHL team welcomed hearing of the successes and how to overcome the challenges and will leverage the offer of continued support from the Cleveland Clinic London team.
In addition, The UHL team are partnering with a higher education institute to formalise an evaluation of NHS unit-dose dispensing and closed-loop medications administration.
Hayley Grafton, CNIO at UHL, is committed to collaboration across boundaries breaking down silos that hinder progress within healthcare systems.
The exchange with Cleveland Clinic London exemplifies the power of shared learning, transcending organizational boundaries to drive meaningful change. Not least it inspired the UHL team to keep going.
“The visit to Cleveland Clinic London and hearing their compelling benefits case (incident reduction, cost and waste savings, medicines tracking), has made us even more determined to succeed,” said Ms Grafton.
While Cleveland Clinic’s purpose-built infrastructure and global network offer unique advantages, their willingness to share insights and lessons learned sets a precedent for collaborative innovation in healthcare.
The concept of standardization and knowledge sharing across sites, prompts reflection on its applicability within the NHS.
Sonia Kelly, CNIO at Cleveland Clinic London, emphasizes the institution’s commitment to community impact and knowledge exchange.
Their pioneering approach to closed-loop medication administration not only enhances patient safety but also fosters a culture of continuous learning and improvement.
The collaborative exchange with UHL reflects a broader vision of advancing healthcare through shared expertise and innovation.
As healthcare leaders navigate the complexities of a rapidly evolving landscape, collaboration emerges as a cornerstone of progress.
The exchange between UHL and Cleveland Clinic London epitomizes this ethos, offering valuable insights into the challenges and opportunities inherent in medication administration initiatives.
By leveraging collective knowledge and expertise, healthcare institutions can pave the way for safer, more efficient patient care.
While implementing fully closed-loop medication administration may present significant challenges, the collaborative exchange between UHL and Cleveland Clinic London demonstrates the potential for overcoming barriers through shared expertise and innovation.
Valuable lessons like navigating the Medicines and Healthcare products Regulatory Agency (MHRA) licencing for production of single units were shared, bringing UHL closer to unblocking challenges.
By leveraging collective knowledge and resources, healthcare institutions can navigate the complexities of implementation, ultimately advancing patient safety and quality of care.
However, to realize the full potential of closed-loop medication administration, national funding and regulatory barriers must be addressed.
Initiatives such as MHRA production licenses pose challenges to widespread adoption, hindering progress and limiting patient access to safer medication practices.
A national drive and commitment to embracing technology that delivers tangible benefits for all patients are essential.
It’s time for policymakers and healthcare leaders to unite in championing innovation and driving forward this transformative solution that delivers impressive patient safety benefits as well as operational and financial efficiencies.
Future Nurse is at the forefront of bringing together expert digital nurse leaders to influence how digital technologies are conceived, developed, and adopted to deliver safe, efficient, person-centred care.
Through initiatives like visits and roundtable discussions, we aim to inform practice and policy, ensuring that the voices of nurses are heard and heeded in the digital transformation of healthcare.
Let us know what’s important to you, and Future Nurse will endeavour to get the conversation started.
Visit futurenurse.uk to share your suggestions and join the movement toward safer, more efficient healthcare through collaborative innovation and digital leadership in nursing.
Natasha Phillips, founder, Future Nurse, Hayley Grafton, CNIO, University hospitals Leicester and Sonia Kelly, CNIO Cleveland Clinic London
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