Action 4.13

Maintain a variety of up-to-date and evidence-based medicine-related information and decision support tools

Ensure that the content of medicine-related information and decision support tools is:

• Current, and consistent with evidence-based prescribing, dispensing, compounding and administration of medicines
• Suitable for the organisation’s patient casemix, care delivery work practices and workflows
• Consistent with the organisation’s policies, procedures and guidelines
• Available in several formats
• Integrated within the organisation’s digital or electronic systems.

Decision support includes any functionality or resource that helps clinicians make the most appropriate decisions for patient care and provides guidance (for example, a medicine-related protocol) or incorporates knowledge (for example, an electronic database of medicine–medicine interactions).

Review the organisation’s range of medicine-related information and decision support tools, including guidelines and protocols. Ensure that they are relevant to the organisation’s range of clinicians, including those who prescribe medicines, dispense (and compound) medicines or administer medicines.

This review should be undertaken by the organisation’s governance group responsible for medication safety, in consultation with clinicians. Any amendments to the existing range of resources could be recommended as a change at the state or territory level.

Ensure that processes are in place for maintaining up-to-date, evidence-based medicine-related information and decision support tools, and making available medicine-related information that is mandated by legislation. Ensure that these processes consider requirements for clinician training and education.

A minimum standard set of medicine-related reference materials could include current versions of:

• Australian Medicines Handbook (AMH) and AMH Children’s Dosing Companion
• Therapeutic Guidelines
• The Australian Immunisation Handbook
• Australian product information and CMI, such as MIMS and AusDI
• Medicine interactions references, such as Micromedex or Stockley’s Drug Interactions
• References on complementary and alternative medicines, such as MedlinePlus Drugs, herbs and supplements
• Australian Injectable Drugs Handbook or local injectable medicines administration guidelines
• Don’t Rush to Crush handbook or local guidelines.

Examples of decision support tools are:

• Formulary information, prescribing requirements and approval systems
• Policy directives, protocols, guidelines and authorised standing orders
• Dosing calculators and medicine-interaction databases
• Reference texts, and telephone-based medicines information and advice services
• Guidelines for safe administration of specific medicines (for example, administering medicines via enteral tubes)
• Selection of treatment in specific clinical situations (for example, appropriate choice of antimicrobial).

Make up-to-date and evidence-based medicine-related information and decision support tools available to clinicians

Access to relevant, up-to-date, evidence-based medicine-related information (reference materials) and decision support tools is essential at all stages of the medication management pathway. It improves clinical practice, improves work practice and workflow efficiencies, supports clinician learning and assists with the provision of information to patients.

A standard set of evidence-based reference materials may be available online through a centralised portal at the state or territory level and at the point of decision-making, including within clinicians’ specialty areas of practice.

Explore and implement suitable technologies to deliver medicine-related information and decision support tools in clinical areas where medicines are prescribed, dispensed and administered – for example, smartphone apps, bedside/desktop computers, tablets and computers-on-wheels.

Include clinical decision support functionality when implementing electronic medication management systems. Comprehensive guidance on electronic decision support can be found in Electronic Medication Management Systems: A guide to safe implementation.

Implement electronic decision support tools as standalone modules when complete electronic medication management systems are not in place (for example, antibiotic approvals and antibiograms as components of antimicrobial stewardship) (see Action 3.15 and 3.16).

Promote the availability and use of information sources (including how to contact medicines information services) and decision support tools using education and communication strategies, including newsletters, presentations, in-house education sessions, awareness campaigns and desktop icons.

Maintain a variety of up-to-date and evidence-based medicine-related information and decision support tools

Ensure that the content of medicine-related information and decision support tools is:

• Current, and consistent with evidence-based prescribing, dispensing, compounding and administration of medicines
• Suitable for the organisation’s patient casemix, care delivery work practices and workflows
• Consistent with the organisation’s policies, procedures and guidelines
• Available in several formats
• Integrated within the organisation’s digital or electronic systems.

Decision support includes any functionality or resource that helps clinicians make the most appropriate decisions for patient care and provides guidance (for example, a medicine-related protocol) or incorporates knowledge (for example, an electronic database of medicine–medicine interactions).

Review the organisation’s range of medicine-related information and decision support tools, including guidelines and protocols. Ensure that they are relevant to the organisation’s range of clinicians, including those who prescribe medicines, dispense (and compound) medicines or administer medicines.

This review should be undertaken by the organisation’s governance group responsible for medication safety, in consultation with clinicians. Any amendments to the existing range of resources could be recommended as a change at the state or territory level.

Ensure that processes are in place for maintaining up-to-date, evidence-based medicine-related information and decision support tools, and making available medicine-related information that is mandated by legislation. Ensure that these processes consider requirements for clinician training and education.

A minimum standard set of medicine-related reference materials could include current versions of:

• Australian Medicines Handbook (AMH) and AMH Children’s Dosing Companion
• Therapeutic Guidelines
• The Australian Immunisation Handbook
• Australian product information and CMI, such as MIMS and AusDI
• Medicine interactions references, such as Micromedex or Stockley’s Drug Interactions
• References on complementary and alternative medicines, such as MedlinePlus Drugs, herbs and supplements
• Australian Injectable Drugs Handbook or local injectable medicines administration guidelines
• Don’t Rush to Crush handbook or local guidelines.

Examples of decision support tools are:

• Formulary information, prescribing requirements and approval systems
• Policy directives, protocols, guidelines and authorised standing orders
• Dosing calculators and medicine-interaction databases
• Reference texts, and telephone-based medicines information and advice services
• Guidelines for safe administration of specific medicines (for example, administering medicines via enteral tubes).

Make up-to-date and evidence-based medicine-related information and decision support tools available to clinicians

Access to relevant, up-to-date, evidence-based medicine-related information (reference materials) and decision support tools is essential at all stages of the medication management pathway. It improves clinical practice, improves work practice and workflow efficiencies, supports clinician learning and assists with the provision of information to patients.

A standard set of evidence-based reference materials may be available online through a centralised portal at the state or territory level and at the point of decision-making, including within clinicians’ specialty areas of practice.

Explore and implement suitable technologies to deliver medicine-related information and decision support tools in clinical areas where medicines are prescribed, dispensed and administered – for example, smartphone apps, bedside/desktop computers, tablets and computers-on-wheels.

Include clinical decision support functionality when implementing electronic medication management systems. Comprehensive guidance on electronic decision support can be found in Electronic Medication Management Systems: A guide to safe implementation.

Implement electronic decision support tools as standalone modules when complete electronic medication management systems are not in place (for example, antibiotic approvals and antibiograms as components of antimicrobial stewardship) (see Action 3.15 and 3.16).

Promote the availability and use of information sources (including how to contact medicines information services) and decision support tools using education and communication strategies, including newsletters, presentations, in-house education sessions, awareness campaigns and desktop icons.

Examples of evidence

Select only examples currently in use:

• Observation that up-to-date decision support tools such as protocols, guidelines and medicine-related information resources are accessible in clinical areas (in electronic or hard copy)
• Orientation or training documents about using decision support tools for medicines
• Communication with the workforce about medicine-related information and decision support tools
• Examples of medicine-related information and decision support tools.

MPSs and small hospitals should maintain a variety of up-to-date and evidence-based medicine-related information and decision support tools and make them available to clinicians.

Access to relevant, up-to-date, evidence-based medicine-related information (reference materials) and decision support tools is essential at all stages of the medication management pathway. It improves clinical practice, improves work practice and workflow efficiencies, supports clinician learning, and assists with the provision of information to patients.

Ensure that the content of medicine-related information and decision support tools is:

• Current, and consistent with evidence-based prescribing, dispensing, compounding and administration of medicines
• Suitable for the organisation’s patient casemix, care delivery work practices and workflows
• Consistent with the organisation’s policies, procedures and guidelines
• Available in several formats
• Integrated within the organisation’s digital or electronic systems.

Ensure that processes are in place for maintaining up-to-date, evidence-based medicine-related information and decision support tools, and making available medicine-related information that is mandated by legislation. Ensure that these processes consider requirements for clinician training and education.

A minimum standard set of medicine-related reference materials could include current versions of:

• Australian Medicines Handbook (AMH) and AMH Children’s Dosing Companion
• Therapeutic Guidelines
• The Australian Immunisation Handbook
• Australian product information and CMI, such as MIMS and AusDI
• Medicine interactions references, such as Micromedex or Stockley’s Drug Interactions
• References on complementary and alternative medicines, such as MedlinePlus Drugs, herbs and supplements
• Australian Injectable Drugs Handbook or local injectable medicines administration guidelines
• Don’t Rush to Crush handbook or local guidelines.

Decision support includes any functionality or resource that helps clinicians make the most appropriate decisions for patient care and provides guidance or incorporates knowledge. Examples of decision support tools are:

• Formulary information, prescribing requirements and approval systems
• Policy directives, protocols, guidelines and authorised standing orders
• Dosing calculators and electronic medicine-interaction databases
• Reference texts, and telephone-based medicines information and advice services
• Guidelines for safe administration of specific medicines (for example, administering medicines via enteral tubes)
• Selection of treatment in specific clinical situations (for example, appropriate choice of antimicrobial).