Leicester’s ePIFFany project successfully reduces junior doctor prescribing errors

Posted by ap507 at May 20, 2014 04:48 PM |
Issued by University Hospitals of Leicester 20 May 2014

Issued by University Hospitals of Leicester 20 May 2014

In collaboration with the University of Leicester and Pfizer, University Hospitals of Leicester NHS Trust has successfully developed and implemented a ‘multifaceted educational intervention’ to increase the skills, knowledge and competence of junior doctors to avoid prescribing errors.

The recent EQUIP study carried out by the General Medical Council’s at 19 hospitals across the UK, found that junior doctors made 8.9 errors per 100 prescriptions across a seven day period; nearly twice as many as consultants, nurses or pharmacists.

The study highlighted how the ‘notion of safety’ was sometimes lacking which in turn prompted Health Education East Midlands to pioneer and fund ePIFFany, a project to ensure junior doctors retain conscious control while problem-solving and decision-making when prescribing complex medications.

Two cohorts of junior doctors who rotated through the John Walls Renal Unit at Leicester General Hospital participated in the four month educational intervention ePIFFany trial.

Dr Rakesh Patel, Specialist Registrar in Nephrology at Leicester General Hospital and NIHR Academic Clinical Lecturer in Medical Education at University of Leicester, explains: “ePIFFany comprises of four teaching components, including real clinician and patient feedback. It‘s designed to increase the insight of junior doctors into their own behaviour, enabling them to keep focused before the mind ‘switches off’ and leads to avoidable harm.”

Results of the trial showed a 50% decrease of medication errors made by the junior doctors who took part, with no serious errors made at all.

Dr Patel continues: “By the end of the four month trial, the junior doctors showed the same performance improvements as those with 12 months of clinical experience which is beyond even our initial expectations for the project.”

The National Patient Safety Agency estimates that avoidable harm from medication errors costs the NHS more than £750 million each year. The project results show a potential £320,000 cost saving from avoidable medication errors with approximately 489 inpatient bed days also being saved.

Dr Margaret Ince from the Leicestershire Kidney Patient Association, an organisation partnered in the development of the project, noted that doctors receiving the intervention had more confidence about themselves. She said: “It was clear they had more confidence, and when they have confidence, you do too.”

Following the successful results, a three minute video abstract of ePIFFany was created and submitted to The Network’s Quality Improvement (QI) Video Competition 2014. The team, led by junior doctor, Dr Robert Jay presented the video at The Network’s QI Conference last week, taking first place and surpassing 17 other competition submissions. 

The ePIFFany developers, partners and team now hope to roll out the study to other clinical setting such as acute or emergency care.

Further information about the ePIFFany project can be found at http://heeminnovation.co.uk/projects/prescribing-project/ and the winning video can be watched at www.the-network.org.uk/  


Notes to Editor
The ePIFFany project was funded by Health Education East Midlands (HEEM), part of Health Education England (HEE). Our goal is to develop a high quality, safe and sustainable workforce to meet the healthcare needs of the people of the East Midlands. HEEM covers the counties of Derbyshire, Leicestershire and Rutland, Lincolnshire, Northamptonshire and Nottinghamshire.

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