The Missing Items Problem

What is the ‘Missing Items Problem’?

Picture this; a care provider manages 50 service-users, 350 medication items must be managed, audited, and administered safely and effectively. Three days before the new cycle date starts, they have calculated that there are only 322 items in total after an entire day of sifting through medicine bags. The discrepancies are written on a scrap piece of paper, noting which items have yet to be delivered and which have been partially delivered with incorrect quantities. 

Now, how do they work out what is happening with the missing items? Again, a long, drawn-out process begins, involving communication with both GP and pharmacy to iron-out any issues before the cycle date. The root of the problem is that information must pass between a disjointed triangle of care settings (GP, pharmacy, and care provider). Each stakeholder needs to be made aware of what the others are doing. 

The ‘missing items problem’ is common throughout the care sector and can arise through a combination of various mistakes and general disjointed communications.

Not knowing the whereabouts of each ordered item can lead to serious safeguarding issues, such as medication not being available for a person.

Additionally, the medications will often arrive intermittently as the appropriate order may not have been dispensed because of missing prescriptions; this can result in insufficient medicine stock and potential medication errors. There is also the issue of wasted staff time, with the need to investigate with both pharmacy and GP regarding the whereabouts of the missing items. Furthermore, medication check-in is a specialised task and care providers will have dedicated, trained personnel who can carry out this duty. When medication arrives in multiple deliveries, staff must be managed accordingly to ensure that the task is carried out by team members with checking-in expertise. This stretches out the check-in process and wastes valuable staff time that can be spent on delivery of care.

From both a GP’s and pharmacy’s perspective, mistakes can also happen due to miscommunication, lack of visibility of what has been ordered, or even key staff being unavailable. A pharmacy is also unaware of prescriptions that are pending approval or have been rejected. Awareness of what has been ordered also helps to prepare a pharmacy for the long dispensing process.

Effective communication across all organisations is key to ensuring that service-users receive the right medication at the right time and that medicine is effectively managed and accounted for

Can Technological Advancement Help Alleviate These Issues?

Many care homes are adapting to technological changes by moving to Electronic Medication Administration Records (eMAR). Digitising the medication lifecycle means that all organisations have a clear overview of a service-user’s medication and helps mitigate risks that cause the ‘missing items problem’. Additionally, while most eMAR systems simplify ordering directly to the user’s regular pharmacy, the exact status of prescriptions is still largely unknown, and GPs are kept out of the loop.

This is why Camascope have worked to release the Proxy Ordering feature as part of the eMAR system. This offers a comprehensive solution to the 'missing items problem’ by sending orders directly into the GP system (EMIS, SystmOne, Vision) whilst ensuring both care provider and pharmacy have visibility of the prescription status.

Real-time visibility into medication stock levels, which are automatically updated when medicine is administered, reduces excessive ordering and medicine wastage. Proxy ordering also helps to reduce transcribing errors that can occur through paper-based ordering. For example, a service-user may require co-codamol having previously been prescribed co-dydramol, and it is easy for a GP to make a mistake when looking at a medicine order slip. Digital ordering eliminates the chances of this type of error.

Whilst it is clear the 'missing items problem' poses significant challenges for care homes, effective management is simple with the right tools and processes in place. Camascope's eMAR system offers a comprehensive solution that enables care homes to track the full lifecycle of medication, from ordering to the GP through to pharmacy dispensing and delivery - with live updates on the order status. By using Camascope, care providers can focus on what matters most - delivering exceptional care to their service-users.

If you’d like to know how Camascope's new eMAR solution can work for your organisation, contact us to find out more.