Benefits
Approach
ePrescribing Masterclass Webex
Kathy Wallis, ePrescribing
Domain expert
11 February 2015
www.england.nhs.uk
Purpose of the Presentation
To provide support to Trusts on Benefits Realisation for ePMA projects
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Why benefits realisation?
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Categorisation of Benefits
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Pitfalls – what goes wrong?
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Rules for Benefits realisation
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Worked example
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New Version of ‘Benefits Realisation for ePrescribing Projects’
www.england.nhs.uk
Why Benefits Realisation?
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Provides part of the economic case for
investment – value for money
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Provides a focus on WHY implement – what
is important to the Trust.
May provide insight on the choice of system:
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www.england.nhs.uk
Why should the Trust implement ePMA?
What is the Trust going to gain through this?
Improve the prescribing process (efficiency;
accuracy; reduce prescribing errors; decision
support)
Improve the communications between ward and
pharmacy (stock control; efficiency)
Integral part of the patient record / clinical process
(complex decision support)
Provides the evidence of a successful
implementation: money well spent
Need to keep in line with business case
promises
Categories of Benefit
• Cash Releasing: reducing costs so that resources can be
allocate elsewhere
• Non-cash Releasing: often efficiency benefits where monies /
resources cannot be allocated elsewhere
• Qualitative: benefit that is of value but cannot be quantified in
financial terms
• Societal: savings are realised outside of the health and social
care system e.g. patients return to work more quickly
www.england.nhs.uk
Pitfalls to Benefits Realisation
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What other initiatives are also taking place – will they impact the
same areas of measure
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What is a potential benefit in one Trust may not be to yours:
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Length of stay
Have processes / resources already been put in place to address the issue?
Baseline measurements are not taken ‘pre-implementation’ making
it impossible to demonstrate any improvement / benefit
The benefit is not available to the organisation, e.g. junior doctor
costs are paid for by the Deanery, not the Trust
Wrong expectations: not all benefits will be delivered on day 1 of
implementation (system optimisation):
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May be slow to see benefits as people ‘learn’ the new ways of working and new
processes ‘bed in’
May need to modify the configuration / processes as you learn how the system
really works
www.england.nhs.uk
Implementation Life Cycle
www.eprescribingtoolkit.com
www.england.nhs.uk
Rules for Benefits Realisation
• Measure what is measurable
• Set realistic expectations for your organisation
• Fit with the local picture
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Trust Strategic Drivers
Local opportunities and needs
• Each benefit should be defined so that it fits one benefit
category. The measure must be appropriate to the benefit
category
• If the benefit can be measured in more than one way (e.g. cash
releasing measure and efficiency measure), the benefit should
be listed more than once, highlighting the benefit category and
measure for each entry
• Each benefit must have an owner and a time plan for delivery
www.england.nhs.uk
Worked Benefits example: Decrease
time for drug rounds
Benefit: Decrease time for drug rounds
Benefit Category: Non-cash releasing
Measure: Time for a drug administration round, calculated per patient
Method for measurement: Audit, before and after implementation of the time for a
drug administration round. Audit all drug rounds on sample wards for a week and
calculate the time taken per patient. Calculate the difference in time per patient for
before and after implementation. This time could then be either:
• Multiplied by average hourly rate of nurse to calculate the cost of time saved;
• Taken as time released to care
Note: this is a crude measure as many factors impact the length of a drug round.
However, it does give an indication of the time the process takes. It is recommended
that this is calculated as the time taken per patient, as drug round size can vary,
even on the one ward, depending on the shift, number of staff on duty etc. An
average time per patient can be extrapolated to wards with similar specialties /
patient groups.
www.england.nhs.uk
Ten example benefits and method of
measurement
Many potential benefits – need to fit your Trust. 10 example
‘generic’ benefit chosen to demonstrate benefits / category of
benefit / method of measurement:
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Decrease in medication errors,
including prescription errors;
administration errors; ADRs
Increase in completeness / legibility
of prescriptions
Decreased number of missed doses
through improved medication
supply and improved records
Decrease in number of drug
transcriptions / chart rewrite (junior
doctors)
Decrease time for drug rounds
(nurse)
www.england.nhs.uk
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Decrease in drug expenditure
Increased protocol adherence:
Antibiotic stewardship
Increased Protocol Adherence
Staff satisfaction
Decrease in drug waste (for
installations of automated drug
cabinets)
New Version of ‘Benefits Realisation
for ePrescribing Projects
• www.eprescribingtoolkit.com
• NHS England website
www.england.nhs.uk