Impact on ability to restrict prescribing access to accredited prescribers enabling compliance with legal requirements
Network members discussed how to improve formulary management where specialist restrictions are in place and to prevent fraudulent prescriptions. They also sought greater visibility and control over Patient Group Directions and controlled substances.
What peers in the network found
Decide where the most benefit can be gained
such as never events, and use resources available to you to get maximum benefit in those areas. Work with what you have, while waiting for more resource or improved functionality. Focus efforts by examining the size of the problem you have with high-risk medicines prescribing
Define clear user access
User access needs to be defined from the start (neither too granular nor too general) and a clear, shared understanding of how restrictive the system will be. For example, users expecting stricter controls than in place may wonder ‘why didn’t the system stop me?’
Effectively manage alert fatigue
Only show high-risk drugs and figure out where alerts should be shown to manage alert fatigue
Consider ways to feedback for learning
Share yearly prescribing data for prescribers to review with supervisors
Email feedback when ‘prescribed in error’ to assist this learning
and build as per definition, or identify where the system can’t restrict or support the governance
What to watch out for
- Maintenance of lists and permissions can be a bigger job than expected and needs ongoing resource
- Could potentially prevent emergency prescribing or delay to patient care if approval is too onerous or done inappropriately
- Need to make sure not to restrict the ability of pharmacists to amend or enforce a prescription
- Restricting, could reduce buy-in for system and increase use of work arounds