Well (1037452) - Improvement action plan

The pharmacy does not adequately monitor and control the risk of providing all of its services, as it does not always make meaningful records of mistakes made when dispensing medicines. And actions taken in response to these are not always implemented. This means team members may miss opportunities to identify repeated mistakes and share learning.

• The pharmacy has been fully trained on the new patient safety reporting tool, QI Tech launched Monday 28th April.
• The expectation has been set with the whole team, through a team huddle, around the reporting of any near misses and any patient safety incidents (PSI), which must be completed in a timely manner.
• Any learning identified from each near miss to be recorded on QI tech at point of error being found. No paper logs to be used.
• Review any learning identified from near misses and patient safety incidents on the monthly patient safety report.
• Near Miss Compliance sent to store twice per week. Monday and Thursday, to ensure compliance is met by the store team. Non- compliance to be addressed if any shortfall occurs.
• To confirm actions from the Near Miss/PSI have been embedded during pharmacy visits.