About Damian Larkin
Damian is the Digital Health Nurse Lead at South London and Maudsley NHS Foundation Trust working as the link between the clinical system, information systems and digital services.
This involves engaging clinical staff to assess their needs and requirements, map their clinical workflows for the adoption and implementation of digital technology across the Trust. This also includes reviewing current processes, highlighting areas of duplication, redundancy and opportunities for improved efficiencies in order to provide improved staff satisfaction.
Damian received a commendation for the 2020 Digital Pioneer Fellowship Empower Award.
Problem: Medicines prescribing and administration. The current processes for medication prescribing and administration is entirely paper-based, labour-intensive, and as a result is vulnerable to errors such as poor handwriting; unclear abbreviations, and/or dosages; ambiguous records of medicines administration; and lost or misplaced paper charts. In addition, when prescriptions are phoned-in or scanned to pharmacy, misunderstood verbal instructions, vague orders and scanning-related problems cause more issues. This means patient safety can be compromised, alongside adverse drug events that can cause medical complications.
Solution: An Electronic Prescribing and Medicines Administration (ePMA) system that is interoperable with the main clinical platform.
Scale: SLaM services cover 4 hospital sites consisting of 52 inpatient wards and 760 beds, 200 community teams and major addictions services across the boroughs of Southwark, Lewisham, Croydon, Bexley, Wandsworth and Lambeth.
Desired impact: To improve care and safety through a reduction in prescribing, dispensing, administration and transcription errors. It will also support clinicians to be better informed using clinical decision-support tools and able to manage medicines more effectively and efficiently. Patients will also benefit from an improved service and over time an electronic record of past medications and allergy history will build up. This will minimise the risk of patients receiving previously ineffective and unsafe medicines or those they cannot tolerate due to side effects.
Progress to date: The project has captured a list of ePMA requirements for inpatient and community teams through working closely with doctors, nurses and pharmacists involved, and mapping their current workflows in order to understand their needs before proceeding to procurement. It also established a steering group for the life of the project that engages all relevant stakeholders. The procurement phase has now been completed and the preferred supplier agreed. With investment from Mind and Body, a KHP initiative, the project has now taken feedback and improved the login process, mapped all active care plans saved on the relevant health record (Care Notes) to automatically flow into the service users’ account meaning they will always have access to the most up to date version. They have also built a calendar which automatically populates via the health record to reduce amount of DNAs. Due to these additions, there has been increased interest from other teams across the Trust.
As a result of being on the Fellowship programme, Damian was invited to speak at the Digital Services Away day. He has recently taken on the role of Clinical Safety Officer for SLaM in the context of health IT.
The elements of the programme that created the most value for me were the Action Learning Set sessions. I learned a lot about different ways to engage people and peoples experience of overcoming resistance to change. They really allowed me to reflect on how I work versus how I might adapt in the future. The difficult conversation session was invaluable and gave me confidence to be able to better manage expectations. The Fellowship always gave me a boost, new ideas, feeling energised with new hints and tips to tackle my project and fantastic networking opportunities.
I am thinking more strategically now – looking at what else is going on in the Trust and identifying new opportunities. I have increased confidence to approach people, sell the vision and see the big picture. The Fellowship has given me direction. Previously I was stumbling a little in the dark. My line manager is encouraging me to explore a CNIO role which I have been seriously considering since I took on the role as Digital Health Nurse Lead.“