ePMAelectronic Prescribing and Medicines Administration

ePMA Testing

June 2014

Presentation outline• About Stockport

• Our ePMA Journey

• System build and associated QA processes

• System testing and processes/documentation

• Lessons learnt

About Stockport• Stepping Hill Hospital based in Stockport

• 736 beds

• Look after a population of over 396,000

in Stockport & High Peak

• Over 5,600 staff

Our ePMA journey

System build - Approach• Where to start?

• We split into 5 areas- Formularies- Order sentences (QuickLists)- Order sets (Protocols)- Rules/intelligence- General configuration

• Focussed on initial areas of rollout and evolved during rollout- Top 200 drugs for first 2 wards and worked from there- Shared Trust/GMMMG formulary- Project team fed into a lot of the configuration decisions

• Ensure someone responsible for each area to help make decisions and for QA purposes- e.g. we have a Pharmacist for each BNF Chapter

System build – QA process• QA process approved by Trust Prescribing Committee (Drug & Therapeutics)

• Involved lots of printouts, screenshots and persuasion

• Mainly Pharmacists, but Clinicians involved for Protocols

Medchart Quicklist checkingData entry by: Date: Checked by: (sign) ___________ Date: ___/___/___

EACH PAGE NEEDS TO BE SIGNEDAnnotate comments and feed back to Sarah

System build – Going forward• Don’t think you’re done on day 1 of go live

• Constant refinement and adjustment in initial months

• Have a process for requesting changes & document everything

• Don’t relax your standards from initial data build

- Everything in test first, sign off, then live use

• Spend time getting ready for surgical areas

- Our anaesthetists have really embraced protocols/order sets

• Now everyone can see the potential

- Requests for development and fresh ideas

System testing – Our approach• Real life scenarios with real life examples

• We have 20 example patients that we prescribe review and administer medications

• Complex patients covering lots of different medications

• Simulate ward environment, follow usual processes (3 days of administrations)

• Ensure each and every element of the system is tested, documentation is key

• Use different logins testing each user role

• Don’t forget to test user permissions

System testing - Documentation• Testing log and issue log are essential

• Log each and every action that is completed

• We split into

• Careful consideration of headings e.g.

• Dual monitor workstation has been indispensable!

- Configuration- Meds on admission- Prescribing- Administration- Pharmacy review &

ordering- Clinical Review

- Drug data- Rules- New features & fixes- Issues resolved since last

version- Reporting- Support module

(back up charts/system monitoring)

- ‘Other’

System testing – Recording issues• Record each and every issue

- No matter how big or small- Whether able to replicate or not- Document which user role you were logged in as

- Keep issue log up to date, review daily during testing period

- Clear screenshots and replication steps are best way of explaining issues

- Where possible share issues and testing experience with other sites

System testing – At point of upgrades

• Once upgrades are complete a basic

set of testing is required to release the

system back to users

• Have a list of basic functions that need

to be tested as part of this process

• The start of ours is shown here, it is 43

steps in total but covers all basic

functions

System testing – Lessons learnt• Ask supplier for details of known issues

• Study release notes and write testing script based on new features and fixes

• Screenshots are key

• Learn from other sites

• Real life charts with real life examples

• Don’t aim to do in one sitting

• Log everything

• Always test printouts, don’t just look at them onscreen

Thank you