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Using the NIMC 2009 in private hospitals

Private hospitals can use the National Inpatient Medication Chart (NIMC). Using the NIMC has safety benefits because:

1. Staff working across public and private facilities will be familiar with it and its safety features;
2. New permanent or casual staff will already be orientated to its design and use; and
3. The NIMC is incorporated increasingly into health professional curricula resulting in newly accredited staff being familiar with the chart from their first day on the ward.

The NIMC has been successfully implemented in private hospitals. However, many hospitals that have done so require doctors to write the prescription for PBS supply on a prescription pad as well as the order for administration on a medication chart.

Adopting the NIMC requires a change management strategy, including communication and education, to inform staff of the NIMC and its safety features, and an implementation strategy to ensure it is rolled out effectively. There is a range of tools to support education, implementation, use and auditing of the NIMC available at the NIMC page

Using the Private Hospital NIMC

Some private hospitals have been using medication charts with tear away sections for pharmacy orders and Medicare Australia payment authentication. There will be challenges for those hospitals to implement the standard NIMC because it will require prescribers to return to prescription pad ordering in addition to writing on the medication chart.

A private hospital NIMC has been developed for facilities using medication charts with tear away sections. It replicates the NIMC design and safety features but incorporates tear away sections for pharmacy orders and Medicare Australia payment authentication.

Private Hospital NIMC (PDF 3608 KB)

Resources to support use of the standard NIMC are applicable to the Private Hospital NIMC and are available on the main NIMC page

Feedback on the Private Hospital NIMC can be sent to mail@safetyandquality.gov.au

Private Hospital Day Surgery NIMC

Private hospitals expressed a need for a day surgery medication chart. The Private Hospital Day Surgery NIMC is an A4 document with tear offs for pharmacy orders and Medicare Australia authentication, and is designed for use in private hospital day surgery settings.

Private Hospital Day Surgery NIMC (PDF 476 KB)

Review of PBS Supply in Private Hospitals and Residential Aged Care Facilities

The Commonwealth Department of Health and Ageing reviewed PBS supply arrangements in private hospitals and residential aged care facilities as agreed by the department with the Pharmacy Guild in the Fourth Community Pharmacy Agreement. The review is available from the department web site at Department of Health and Ageing Pharmacy Fourth Community Pharmacy Agreement Reviews web site.

Finding 1 of the review (at page ix) was that “The option of using the patient’s / resident’s medication chart in a RACF / private hospital as the PBS prescription was overwhelmingly supported by stakeholders.”

The Fifth Community Pharmacy Agreement provided for introduction of “supply from a medication chart instead of requiring a prescription” in residential aged care facilities. While no further information is available currently on extension of scriptless prescribing to private hospitals, it is likely that the arrangements being developed for residential aged care facilities in relation to scriptless prescribing will be appropriate for private hospitals.

The Commission will continue to promote the safety benefits of scriptless prescribing.

Private Hospital NIMC National Round Table

The Commission hosted a meeting of nearly 30 private hospital representatives on 2 June 2011 to discuss private hospital experiences with the NIMC. The meeting chairman, Mr Kim Knoblauch (National Manager Risk and Quality for the Calvary Group), introduced the event as an opportunity to:

• Consider private hospital use of the National Inpatient Medication Chart (NIMC) since 2005;
• Provide feedback on private hospital issues with the NIMC; and
• Reinforce the benefits of standardisation in relation to the NIMC.

Participants agreed the most pressing safety issue for private hospitals in relation to the NIMC was scriptless prescribing. Members noted the inequity in the requirement for private hospitals to maintain separate signature slips rather than using the medication chart as both the order for administration and the prescription for PBS supply. They charged the Commission, on behalf of private hospital representatives, with seeking an extension of scriptless prescribing in private hospitals as a matter of urgency.

A number of other action items were also agreed including:

• Providing more NIMC educational resources for ongoing education of staff;
• Communicating to private hospitals the large range of existing NIMC support materials;
• Making available private hospitals versions of all NIMC specialist charts with separate signature slips.

Private Hospital NIMC National Round Table Meeting Record and Outcomes (Word 135 KB) contains key discussion issues and action items arising from the meeting.

Private Hospital Sector Committee

The Commission engages with the private hospital sector primarily through its Private Hospital Sector Committee. The Committee brings together private hospital owners, managers, funders and practitioners working in the sector.

The Committee advises the Commission on safety and quality initiatives and issues in the private hospital sector. It is chaired by Ms Christine Gee, a board member (and former national president) of the Australian Private Hospitals Association, and a private hospital manager.

Updated: 18 September, 2009

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