The proposal aims to improve medication management for elderly patients living at home through a new "talkback" system. It would systematically check patient understanding of medications at every healthcare interaction. Key activities include developing guidance, testing in a pilot, training staff across community pharmacy, GP, hospital pharmacy, nursing, and social care. Successful outcomes include increased patient self-management skills, independence, and reduced waste and errors. Risks include not identifying cognitive impairment, poor communication between organizations, and costs being uncertain.

1. Business Case
of Your Proposal
Team A
Implementing talkback
04 July 2013
Safer Medicine Management amongst Older People Living in their Own Homes

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Team
• Team Coordinator: Steve
• Team members: Mike, Ravjyot, Katrina,
Rosaire, Irina
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Proposal
• Talkback represents a system wide change that is
underpinned by the principle that well informed patients are
more likely to manage their medicines effectively, without
waste and error and to maintain health and independence for
longer and with less support from services.
• The team are proposal a model that will aim to shift all health
and social care providers of systematically checking patients
understanding of medication management issues at every
interaction on medicines related matters
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Service User Segments
• Elderly
• Poly-pharmacy
• Carers (formal and informal)
• Cognitive impairment
• Housebound
• Non English speaking
• Nothing to learn
• Something to learn (want to or not)
• Wont ever learn
• RISKS; missing cognitive impairment, social barriers
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Value propositions
• Better relationships
• Less drugs
• Medicine reconciliation
• Myth busting
• Triage towards help
• More honesty
• Less error
• Better process
• RISKS-opportunity cost; oversimplification
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Channels
• Community pharmacy
• GP
• Hospital pharmacy
• Community nurses
• Carers
• Risks: poor inter-professional communication; too busy to change;
resistant to change
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Service User Relationships
• Advising
• Signposting
• Facilitating
• Doing for
• Risks: alienation, challenging expectations; damaging relationships
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Outcomes
• Self confidence
• Independence
• Self management skills
• Less waste
• Less ADRs
• Easier for staff
• Better health
• Less admissions
• Risks: More work, no outcomes
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Key Activities
• Agree script
• Assess comprehension
• Assess barriers to comprehension
• Agree scope of services
• Map service gaps
• Map solutions
• Agree pathways
• Training and dissemination plan
• MURs and NMRs
• Risks: unmet need
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Key resources
• Time
• Inter-service communication platform
• Supporting materials
• Training resources
• More MURs
• Consistent scripts
• Risks: failings in information exchange
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Key Partners
• Patients and carers
• Pharmacist
• Nurses
• Doctors
• Social workers
• Therapists
• Charities
• NHS organisations
• Managers, Boards
• Risks: intransigent organisations, or staff
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Expenditure
• Training: £2000
• MDT workshops: £2000
• Additional MURs: £30,000
• New nursing role: £30,000
• Risks: costs are guessed
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Risk
• Missing cognitive impairment or social barriers
• Poor inter-professional communications
• Too busy to change
• Alienation, challenging norms, damaging relationships
• Identify unmet need
• Poor communication platform
• Intransigent organisations or staff
• Costs are guessed
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Milestones
• Develop guidance and pathways: month 3
• Test in pilot: month 6
• Develop training and dissemination: month 9
• Deliver training and disseminate: month 18
• MURS NMRs information systems: years 2-4
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