Page 50 - Q BULLETIN, Ministry of Health Malaysia, VOLUME 1, NO. 31 (SUPPLEMENT 1), JAN-DEC 2022

Q Bulletin, Volume 1, No. 31 (Supplement 1), Jan - Dec 2022
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11 National QA Convention, 4 – 6 October 2022
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Increasing the Percentage of Discharge Prescriptions Dispensed through Bedside
Dispensing in Hospital Kajang

Dzatil Awatif Y , Lim LL , Tan KZ , Noor Hidayah R , Alia Zubaidah B , Tan MC 2
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1 Pharmacy Department, Hospital Kajang, Selangor
2 Medical Department, Hospital Kajang, Selangor
SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:
Medication discrepancies were commonly observed among patients discharged from the ward, leading to
potential adverse drug events (PADEs). This can be avoided via Bedside Dispensing (BD). However, the total
discharge prescription dispensed through BD was only 30.6%.

KEY MEASURES FOR IMPROVEMENT:
The indicator measured is the percentage of the discharged prescription dispensed through BD. The standard
is set at 50% based on the 2018 Plan of Action (POA) of the Pharmaceutical Services Division, Ministry of
Health Malaysia (MOH).

PROCESS OF GATHERING INFORMATION:
A quality improvement study was conducted using universal sampling. The percentage of BD was collected
from all wards utilising a data collection form.

ANALYSIS AND INTERPRETATION:
During the verification study, only 28% of discharged prescriptions were successfully dispensed through BD.
This low percentage is mainly due to BD services being provided to limited wards (28%), specialists deciding
to discharge a patient after prescription collection time (19%), doctors prescribing after prescription collection
time (18%) and patients not being keen to wait (17%).

STRATEGIES FOR CHANGE:
Remedial strategies were developed based on verification study findings, including expanding the services
from one session (10 am – 12 pm) to 8 am – 5 pm working hours and creating notification stickers for BD.
Amenities such as Medstocks and BD-Wheels were created to shorten the medication counselling process
time. All the remedial measures were done together with awareness training activities.

EFFECT OF CHANGE:
The percentage of BD improved from 28% to 38% in cycle 1 and successfully achieved more than the standard
set (≥50%), which was 68% in cycle 2. The patient satisfaction survey improved to 83%. 29 PADEs were able
to be avoided during BD. BD also indirectly improved the percentage of patient waiting time in the Pharmacy
Outpatient Department as discharged prescriptions received during peak hours were reduced.

THE NEXT STEP:
To introduce a mobile discharge pharmacy which can be done at a single checkpoint.

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