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Kupu Taurangi Hauora o Aotearoa

Ringing the changes

Beth Loe

August 2011


Change register – why?

Year 2011 – National Medication Chart

Year 2016 – 20 or more medication charts



Post implementation change register

• Identification of issues that do not relate to NMC e.g.

prescribing and administration practice

• Identification of specific features that do not function

as intended in practice

Future change register

• Changes in clinical practice

• Law changes



Engaging clinicians

(paper based or electronic system)

• Advertise

• Annual blitz

• Put it on meeting agendas


Local process

• Have a locally agreed form (paper or electronic)

DHB staff to complete

Date:

Organisation: Ward / unit:

Author: Contact details:

Brief description of proposed change:


Local Committee

• Needs to be multidisciplinary

• Could be: NMC project team

Medicines Advisory Committee

Medication Safety Committee


Stage 1

Complete NMC proposal for change formEach DHB collates suggested changes and classifies all proposed changes to the NMC using the

following process

Question 1.

Is there local evidence

of an issue with the

NMC design

that compromises

patient safety?

Question 2.

Does local evidence

suggest that the

proposed change will

improve patient

safety?

DHB NMC designated

committee rejects

proposal for change

Question 3.

Does the proposed

change comply with

the medication

charting standards?

Go to

question 2

Change approved by

DHB NMC designated

committee

Go to Stage 2DHB NMC designated

committee can still approve

change and proposal

go to Stage 2

Yes

Yes

Yes No

No

No


Why have a local decision

• Additional information can be added to a change request

if necessary

• Respond Yes or No to change request knowing local

situation

• Provides guidance to national design sub-committee on

change requests


Stage 2Submit proposal for change to the national NMC

design committee

Stage 3

Reporting decisions to stakeholders

Submit NMC change form

The DHB NMC

designated

committee will:

The national NMC

design committee,

with its governance

endorsement will:

Inform stakeholders

of proposal for

change status i.e.

accepted / rejected

locally / nationally,

including rationale

Facilitate DHB-wide

change management

process to implement

revised NMC

Inform DHB NMC

designated

committees of

national decisions,

including rationale

Revise NMC with

national printer and

advise DHB NMC

designated

committee when

available

Provide recommendation

to approve or further

investigate

Provide evidence and

rationale


Electronic

Change

Register (ECR)


Electronic Change Register (ECR)

• Details to be sent to DHB NMC project leads

next week

• Log in will be for an individual in each DHB


Help File


Help Files

• Process for local committee review

• Information for submitters for the electronic

change register


National Design Subcommittee

• Has reported to SQM Group but will report to

new Expert Clinical and Technical Advisory

Group

• Multidisciplinary with nurses, doctors and

pharmacists


First Design Review

• Work starting now

• Completion expected between February/April 2012

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