Greatest benefit from using SCR could be realised out-of-hours when GP surgeries are closed and in circumstances where information from relatives is unobtainable. This project assessed application of SCR and its impact on patient safety when used by clinical pharmacy staff working on MAU at weekends. The study was conducted over 12 weekends on an MAU at a district general hospital. Pharmacy staff working on the unit were asked to record every time SCR was accessed and whether its use resulted in an intervention; further classified into those which involved critical medicines and those with the potential to cause harm, as defined by the National Patient Safety Agency2. Data were analysed descriptively in MS Erlotinib Excel.

Ethical approval was not sought as this was a service evaluation. Over 12 weekends, 480 new patients were assessed by the pharmacy team working on MAU. Staff accessed the SCR for 183 of these patients (38.1%); information was available for 146 patients (79.8%). Of the 146 patients where the SCR was signaling pathway used, 90 patients (61.6%) had an intervention that was a direct result of having access to the SCR. This equates to 18.8% (90/480) of all patients. There were 294 interventions (average: 3.3 interventions per patient; SD 5.2; range 1 to 30). The main intervention type was regular medicines not being prescribed; 28 (9.5%) interventions involved critical medicines; 48 (16%) interventions involved patients

potentially at risk of harm if intervention had not been made. All intervention categories are detailed in Table 1. Table 1: Intervention categories for all, critical medicines, and interventions to avoid potential harm Category Number of interventions Number of interventions involving 2-hydroxyphytanoyl-CoA lyase critical medicines Number of interventions where potential harm was prevented Regular medication not prescribed 199 (67.7%) 14 (50.0%) 17 (35.4%) Allergy missing

or incorrect 45 (15.3%) 10 (35.7%) 16 (33.3%) Dose or strength incorrect 34 (11/6%) 1 (3.6%) 12 (25%) Frequency incorrect 8 (2.7%) 1 (3.6%) 2 (4.2%) Wrong medication stopped 7 (2.4%) 0 (0%) 1 (2.1%) Timing incorrect 1 (0.3%) 0 (0%) 0 (0%) Totals 294 (100.0%) 28 (100.0%) 48 (100.0%) This project has shown that one out of every five patients assessed on an MAU had an intervention that improved prescribing when the SCR was used by Pharmacy staff. In a significant minority of patients the intervention reduced potential risk of harm. For patients requiring hospital care during weekends, the SCR allows healthcare professionals to access essential clinical information that would otherwise be unavailable. Future work would include a statistical comparison against a service not using SCR during their medicines reconciliation process. 1. Greenhalgh T.,Stramer K.,Bratan T. et al. Adoption and non-adoption of a shared electronic summary record in England: a mixed-method case study. BMJ 2010; 340: 1468–5833. 2. NPSA.