Implementation of the National Inpatient Medication Chart in Victoria
Background of the change process was monitored through an electronic Discussion
• In April 2004, all Australian Health Ministers stated a commitment implementation register, where perceived barriers and enablers • The methodology was found to be effective in change
to the implementation of a National Inpatient Medication Chart were also registered. Proposed changes for the design of the NIMC management.
(NIMC) across all public hospitals, to improve patient safety were captured via an electronic change register. A standardised
• Feedback indicated that the workshops were an effective
through standardisation of documentation. audit tool was provided to all health services.
strategy for exchanging information required by the project teams
• Communication can be made safer throughout the medication • contingency planning: A Victorian Medicines Advisory Committee to implement the NIMC.
management pathway with standardisation of documentation, (VMAC) NIMC working party was established incorporating
• The implementation register was a valuable method for tracking
based on best practice members with expertise in QUM, including the development
change and identifying issues on a statewide basis.
and implementation of the NIMC. This working party addressed
• In June 2005 there was no standardised inpatient medication chart • Feedback from stakeholder meetings indicated that a range
perceived barriers to the implementation process.
used throughout public hospitals in Victoria. of communication strategies was important in reaching healthcare
• The implementation of the NIMC in Victoria required organisational professionals at all levels within an organisation and facilitating
change on a statewide basis, with the aim of standardising best feedback from healthcare professionals to the state coordinator.
practice to improve patient safety. • The change register was important in maintaining a broad
perspective on changes required, to avoid individualisation
Aims Results of the NIMC by each health service.
To implement a standardised inpatient medication chart in public Workshop evaluations
hospitals across Victoria • 92 per cent of delegates rated the quality of the workshops Future
to be good/excellent • Further evaluation of each component of the change management
Method • 97 per cent of delegates stated that the workshop would help them process will be conducted.
The change management process included the following elements: to implement the NIMC • Evaluation of the impact of the NIMC on patient safety will also
• rationale for change: Reduction in patient harm through be conducted.
standardisation of documentation Implementation register • The VMAC aims to further develop the communication network
• tools to assist the change process: The Quality Use of By June 2006, around 50 per cent of regional and rural health between QUM partners to facilitate consultative, collaborative
Medicines (QUM) program, Department of Human Services services had implemented or committed to the implementation change management to implement other patient safety initiatives.
(DHS), Victoria, developed and adapted guidelines, presentations, of the NIMC and most of the metropolitan health services had
poster templates, implementation plan templates, audit tools and committed to the implementation of the NIMC, by January 2007. For further information please contact:
‘frequently asked questions’ sheets and made them available Rural hospitals using electronic prescribing were excluded from
this phase of implementation.
firstname.lastname@example.org or visit our website
on a dedicated website.
• education: Seven workshops were held in rural, regional and www.health.vic.gov.au/vmac/projects/nimc.htm
metropolitan locations to share information, facilitate planning,
address barriers and provide tools to facilitate the implementation The following recommendations for change were approved
process, through a ‘train-the-trainer’ style approach. • Removal of the discharge dispensing section where
• communication: A communication plan was developed that Pharmaceutical Beneﬁts Scheme discharge prescriptions are used
included workshops, conference presentations, a website, • Punch holes moved from the centrefold to the left hand side
publications, fact sheets, stakeholder meetings, letters and email • Warfarin dose time adjusted from 1600 hours to 1800 hours
brieﬁngs. These were coordinated by the Senior Adviser, QUM in rural and regional settings, to allow visiting medical ofﬁcers
program, DHS. to review blood test results before prescribing.
• evaluation: The workshops were evaluated for quality and Further recommendations for change were addressed during
ability to equip the delegates to implement the NIMC. The extent education sessions without the need to make changes to the NIMC.