We maintained the acute clinical pharmacy while working from home during the COVID-19 pandemic

While the COVID-19 pandemic is largely a natural disaster, the best protection for our clinical pharmacy services at NHS Lanarkshire (NHSL) has been remote work technology.

When I took on the role of Senior Pharmacist in July 2020 at the NHSL – full of enthusiasm and ideas, despite the dark cloud of the pandemic – I underestimated the scale of the challenges that lay ahead, including around the workforce and the continuity of services.

However, I was quickly informed that we could allow clinical pharmacists and technicians to work remotely from the services of the pharmacy department and from their homes, if necessary. I was delighted to see how it worked in practice; the pandemic had introduced unique implications for the protection and absence of staff.

The move home for our team was relatively quick and in place prior to my arrival in the role. It was initiated by the need to allow one of our pharmacists at Hairmyres University Hospital (UHH) to continue working, despite having to protect themselves at home.

Two of the NHSL sites, UHH and Monklands University Hospital, can use eHealth systems through secure remote access. The main one is the Hospital Electronic Prescription and Administration (HePMA) system, which allows us to remotely manage the prescription and administration of drugs. HePMA has been in place at Monklands for years, but only at UHH since September 2019. Deployment of HePMA to our third NHSL site, Wishaw University Hospital, is scheduled for 2021.

Together with HePMA, PharmacyView, the NHSL Clinical Portal, Microsoft Teams, Emergency Care Summary and Online Labs make up our core “eHealth suite”. These systems allowed our teams to easily contact their colleagues and clinics, and prioritize patients. They were able to continue to perform tasks such as single-source medication reconciliation, reviewing electronic prescribing tables, accessing electronic nursing transfers, drafting and reviewing electronic pharmaceutical care plans, and reviewing electronic nursing care plans. clinical screening of discharge orders, all using these systems.

Working as part of a home clinical service is certainly a unique experience. Our protective pharmacist said that despite his discomfort at the start of the pandemic, obtaining secure remote access allowed him to go to work without traveling and allowed him to better manage his chronic health condition. She says not being able to contribute, maintain her knowledge and skills, and connect with the team would have been torture. I was delighted that we had this option; the well-being of the team has been a key priority throughout the pandemic.

Her adaptability, confidence and commitment paved the way for our manager to gain secure remote access for the entire clinical team, and they were advised to bring their laptop or tablet home every day. evenings in the event of needing to self-isolate.

The team learned from the experience of our pharmacist. She says what has helped her work more smoothly is having consistent ward areas and patients to review, the introduction of electronic pharmacy care planning throughout the ward and stay in touch with colleagues through Microsoft Teams. Maintaining close contact with the multidisciplinary team of its telephone services was also essential.

This is not an ideal way to provide clinical service. Patients and their medical notes are not directly accessible. Communication can sometimes take a long time and reconciliation of single-source drugs is not preferred. Whenever a problem is identified, telecommuting pharmacists perform what can be considered an extended risk assessment: best course of action, urgency, and impact.

But I wonder, without secure remote access, would our acute services have been forced to be reduced to a dispensary function only?

Electronic systems are only good in the information they obtain, the environment in which they are used and the expertise of the user. The unprecedented level of continuity of service and connection achieved by our clinical teams is a testament to their commitment, adaptability and capacity for innovation in what can only be described as extraordinary circumstances. As a new manager, I will be eternally grateful to them and for these options.

Ruth Waters, Senior Pharmacist – Clinical Services, University Hospital Hairmyres, NHS Lanarkshire

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