scholarly journals Codeveloping an effective EMPA to maturity in an acute NHS Trust: an implementer report

2022 ◽  
Vol 29 (1) ◽  
pp. e100477
Author(s):  
Geeth Silva ◽  
Tim Bourne ◽  
Graeme Hall ◽  
Shriyam Patel ◽  
Mohammed Qasim Rauf ◽  
...  
Keyword(s):  
Big Bang ◽  
Error Rates ◽  
Alternative Methods ◽  
Electronic Prescribing ◽  
University Hospitals ◽  
Clinical Workflow ◽  
It Systems ◽  
Agile Approach ◽  
The Big Bang ◽  
Roll Out

IntroductionUniversity Hospitals Leicester has codeveloped, with Nervecentre, an Electronic Prescribing and Medicines Administration System that meets specific clinical and interoperability demands of the National Health Service (NHS).MethodsThe system was developed through a frontline-led and agile approach with a project team consisting of clinicians, Information Technology (IT) specialists and the vendor’s representatives over an 18-month period.ResultsThe system was deployed successfully with more than a thousand transcriptions during roll-out. Despite the high caseload and novelty of the system, there was no increase in error rates within the first 3 months of roll-out. Healthcare professionals perceived the new system as efficient with improved clinical workflow, and safe through an integrated medication alert system.DiscussionThis case study demonstrates how NHS trusts can successfully co-develop, with vendors, new IT systems which meet interoperability standards such as Fast Healthcare Interoperability Resources, while improving front line clinical experience.ConclusionAlternative methods to the ‘big bang’ deployment of IT projects, such as ‘gradual implementation’, must be demonstrated and evaluated for their ability to deliver digital transformation projects in the NHS successfully.

scholarly journals Patient-centric implementation of an electronic medication management system at a tertiary hospital in Western Sydney

2018 ◽  
Vol 25 (3) ◽  
pp. 169-175 ◽  
Author(s):  
Naren Gunja ◽  
Ian Dunlop ◽  
Milan Vaghasiya ◽  
Kevin Kuan ◽  
Simon Poon
Keyword(s):  
Medication Management ◽  
Tertiary Hospital ◽  
Big Bang ◽  
Electronic Prescribing ◽  
Implementation Model ◽  
Tertiary Teaching ◽  
Tertiary Teaching Hospital ◽  
Group Interviews ◽  
Patient Centric ◽  
Roll Out

BackgroundTraditional implementations of electronic medication management (EMM) systems have involved two common formats – a ‘big bang’ approach on the day of go-live, or a phased ward-by-ward approach over months.ObjectiveTo describe the patient-centric roll-out, a novel implementation model in converting from paper to EMM.MethodThis model iteratively converted a large tertiary teaching hospital to electronic from paper medication charts, commencing the roll-out in the emergency department (ED). The tenet of ‘one patient, one chart’ was maintained with new patients commenced on EMM, while existing inpatients were maintained on paper charts until their discharge. In the second week, all other intake points commenced patients on EMM, and in the third week, all remaining patients were manually converted to EMM. The implementation was assessed with training completion rates, staff satisfaction surveys, focus group interviews and incident logs.ResultsAt go-live, 79% of doctors, 68% of nurses and 90% of pharmacists were trained in the EMM system. The ED converted to electronic prescribing within 24 hours; by day 20, all patients were on EMM. Two hundred and thirty issues were logged, none critical, of which 22 were escalated. Of the 51,063 medications administered, there were 13 EMM-related clinical incidents including three double dosing errors, none of which led to an adverse event or death. Overall, 77% of staff surveyed were satisfied with the EMM implementation.ConclusionsThe patient-centric roll-out model represents an innovative and safe approach with a single medication chart reducing transcription and improved medication safety for the patient and the organisation.

A view of the universe before the big bang

2006 ◽  
Vol 190 ◽  
pp. 15-15
Author(s):  
D CASTELVECCHI
Keyword(s):  
Big Bang ◽  
The Big Bang ◽  
The Universe

The First Galaxies in the Universe

2013 ◽  
Author(s):  
Abraham Loeb ◽  
Steven R. Furlanetto
Keyword(s):  
Galaxy Evolution ◽  
Big Bang ◽  
First Stars ◽  
Distant Galaxies ◽  
Formation And Evolution ◽  
Early Galaxies ◽  
First Galaxies ◽  
Large Telescopes ◽  
New Generation ◽  
The Big Bang

This book provides a comprehensive, self-contained introduction to one of the most exciting frontiers in astrophysics today: the quest to understand how the oldest and most distant galaxies in our universe first formed. Until now, most research on this question has been theoretical, but the next few years will bring about a new generation of large telescopes that promise to supply a flood of data about the infant universe during its first billion years after the big bang. This book bridges the gap between theory and observation. It is an invaluable reference for students and researchers on early galaxies. The book starts from basic physical principles before moving on to more advanced material. Topics include the gravitational growth of structure, the intergalactic medium, the formation and evolution of the first stars and black holes, feedback and galaxy evolution, reionization, 21-cm cosmology, and more.

The Planet in a Pebble

2010 ◽  
Author(s):  
Jan Zalasiewicz
Keyword(s):  
Solar System ◽  
Volcanic Eruptions ◽  
Big Bang ◽  
Forensic Analysis ◽  
Mineral Matter ◽  
Supernova Explosions ◽  
Deep Underground ◽  
The Big Bang ◽  
The Universe

This is the story of a single pebble. It is just a normal pebble, as you might pick up on holiday - on a beach in Wales, say. Its history, though, carries us into abyssal depths of time, and across the farthest reaches of space. This is a narrative of the Earth's long and dramatic history, as gleaned from a single pebble. It begins as the pebble-particles form amid unimaginable violence in distal realms of the Universe, in the Big Bang and in supernova explosions and continues amid the construction of the Solar System. Jan Zalasiewicz shows the almost incredible complexity present in such a small and apparently mundane object. Many events in the Earth's ancient past can be deciphered from a pebble: volcanic eruptions; the lives and deaths of extinct animals and plants; the alien nature of long-vanished oceans; and transformations deep underground, including the creations of fool's gold and of oil. Zalasiewicz demonstrates how geologists reach deep into the Earth's past by forensic analysis of even the tiniest amounts of mineral matter. Many stories are crammed into each and every pebble around us. It may be small, and ordinary, this pebble - but it is also an eloquent part of our Earth's extraordinary, never-ending story.

When did the Big Bang happen?

1996 ◽  
Vol 10 (1) ◽  
pp. 33-33
Author(s):  
F. A. Tsitsin
Keyword(s):  
Big Bang ◽  
The Big Bang
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