Your green Medicine Bag - (#1849)

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Innovation 'Elevator Pitch':
Your green Medicine Bag -
A regional re-invigoration of the Green Bag Scheme
Overview of Innovation:
Medication errors occur most commonly at the interfaces of care, particularly at admission. The transfer of patients medication on admission to hospital, using a green medicine bag, is one method to help support effective medicines reconciliation and therefore reduce medication errors.

A ‘Green Bag’ is simply a clearly designated, easily identifiable bag which can be used for transporting medicines between and around care settings. The purpose is to keep all the medicines belonging to a patient together in a readily identifiable container. Taking medicines into hospital is one of many tasks for ambulance clinicians, and needs to be as simple as possible. Having a single West Midlands design of green bag across the region makes it easier for the WM ambulance service logistically and helps crews to recognise the bags.  In addition, purchasing Green Bags in bulk across the West Midlands health economy makes it a more cost-effective initiative and enables a consistent message to be given to patients across the region.

There are many potential benefits that can be derived from introducing or re-invigorating Green Bags into practice including reducing prescribing errors, omitted and delayed doses, medicines waste, time spent on drugs administration, patient confusion with medication post discharge and time spent waiting for discharge medication.  Green Bags also increase cost effectiveness, patient involvement with their medication and time for patient care.

From Monday 4 April 2016, the Green Bag scheme will launch across the whole of the West Midlands. The WMAHSN's transfer of medicines programme encourages patients to take all their own medicines with them if they have to go into hospital. For patients transferred to hospital by West Midlands Ambulance Service, a regional Your green Medicine Bag will be used to bring patients medicines into hospital with them.

To support the launch of the scheme, a Your Green Bag in an emergency and a reminder patient poster have been produced. 

A host of other resources, to enable trusts and clinical commissioning groups to promote the scheme, are available, including:
  • Template presentation for staff training
  • A presentation that could be uploaded onto screens in GP waiting rooms
  • Healthcare staff posters
  • Patient information leaflets.
If you have any queries, please contact bethan.knight@uhb.nhs.uk or the Your Green Medicine Bag scheme team at yourgreenmedicinebag.westmidlands@nhs.net.
 
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
Similar Content1
Innovation 'Elevator Pitch':
Digital Transfer bag for essential clinical patient information such as medical, falls and frailty information, diet/nutrition/hydration etc. To improve patient safety and provide important information to HCP's for patients conveyed.
Overview of Innovation:
Creation of a Digital Transfer bag for essential clinical patient information such as medical information, falls and frailty information, diet/nutrition/hydration etc. To improve patient safety and provide important information to Health Care Professionals for patients conveyed to Emergency Departments, hospital appointments or occupational therapy services. The app can also incorporate additional elements that will help to tailor their care such as an electronic falls risk assessment (eFRAT), simple initial questionnaires i.e. recent coughs and colds, general health, mental health, stability checks. Integration of Point of Care testing such as UTI testing for symptomatic patients. Results can be emailed to GP/ night nursing services for treatment prescription if required. Quick identification and treatment can improve patient experience and reduce falls risk associated with UTIs.
Stage of Development:
Ideas stage - Early concept and ideas stage
WMAHSN priorities and themes addressed: 
Long term conditions: a whole system, person-centred approach / Wellness and prevention of illness / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Frail older people living in care homes are amongst the most vulnerable in our society.  Often simple referrals for outpatient clinics are aborted due to lack of sufficient information available and availability of knowledgable staff to accompany the patient.  Calls to paramedics result in conveyances for the same reason.
Within a care home when someone is conveyed to hospital they must be accompanied by a member of staff, this could be any one who is available, and they may not have a lot, if any, medical knowledge or knowledge of the persons previous health. Using an app would mean anyone would be able to travel to hospital with the patient as they would have all the information they would require on admission.
Currently personal and clinical information and standardised paperwork is being sent along with the patient in the ambulance. This opens up the possibility of sensitive data being lost, or not passed on to the care team who need it. The app would store encrypted data within the N3 network. Could utilise DM+D (Dictionary of medicines and devices) to reduce input error for medication information.
Ideally this could be operated in a phased approach with basic services initially and others added on in a second phase.
Care homes provide a vital service within the national health and care system, however due to insurance requirements many have become increasingly risk-adverse, insisting that the slightest stumble, confusion or change in a patient be medically reviewed.  With falls alone this results in calls to ambulance services that often result in unnecessary conveyance because the information is not routinely available.  Clinical, paramedic and patient time is wasted due to repeated appointments and attends due to insufficient information available at the point of incident.
 
Benefit to WM population:
Improved, faster treatment for illnesses, remote monitoring by qualified staff reducing need for appointments and long waiting times.  Nominated professionals and individuals can hold virtual consultations using shared information.
Current and planned activity: 
Early engagement and development has been discussed as part of an existing AHSN project in the East Midlands, but this area of work is not part of that project, and has been identified as an area of innovation and improvement.
A digital platform is already available and can quickly be tailored to deliver many of the requirements here, and this constitutes the current Phase of the work.
Next steps would be to engage with selected homes of both residential and nursing home categories and varying sizes to test performance, with the aim to roll out within a twelve month period.  
The following developments would be to work with other innovation partners to integrate with others digital technology platforms to support care homes in managing their patients, it would also be further developed to enable roll out in assisted living, sheltered housing and residential properties.
What is the intellectual property status of your innovation?:
This product is in development, and this is the first time we have shared it as we are now at the point of needing further advice and assistance.  WMAHSN have been approached to support us on protecting the IPR for this innovation.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
3
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
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