| Should the team print Medchart EPMA to paper and then use that paper chart to transcribe to Nervecentre EPMA? | Paper drug charts must remain on the ward for drug administration and emergency prescribing. Thus, transcribing would have to be done on or near the ward. Once drug charts are printed the old application can be made view only for the whole ward that is transitioning. This avoids two live electronic drug records for a patient and risk of dual records causing confusion especially with remote prescribing ability.
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| Should the transcribing take place on the ward or in a remote location? | During the pandemic it was necessary to minimise staff working on the ward. Wards are busy places and often do not have many free computers or desk space that would be needed by a transition team. If transitioning without paper it is probably easier to use a remote location set up specifically for the task in hand. The team therefore decided to conduct the transition process away from the ward.
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| How long should two live EPMA applications overlap for a patient? | The Team aimed to keep this to a very short period (2–3 hours). During this window, there is a risk of drugs being prescribed or administered on the wrong application. The time taken to transition a whole ward will depend on the number of patients and size of the transition team.
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| How do the team prevent the wrong EPMA application being used for a patient? | Keep the overlap window to a minimum. Turn off the prescribing function (but not administration) when the transition process started for a particular ward. All new patients on the day of transition have medications prescribed on the new application. Clear staff communication about the process and risks. Use identifiers on the ward whiteboard of patient names or patient bed to indicate which application the staff needed to use. For example, a new admission is on the new application but they are moved to a ward that is not transitioning until later in the day.
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