Clinical Indications Seamless Delivery: Departure and Destination Audits

By Nigel Masters, April 2006

Seamless delivery of clinical indications linked to prescriptions involves many parts of the healthcare process. One way this can be validated is by the use of departure and destination audits. In a hospital setting audits can be carried out by checking ward drug charts (departure audit) and then checking discharged patients medicines packets to ensure listing of clinical indications. (The destination audit). In Primary care departure audits can occur by checking repeat scripts production at the health centre and destination audits by checking medicine management listings at nursing or residential homes. Examples in primary care are shown below.

Departure Audit – Primary Care
Repeat prescriptions are checked to ensure high levels of indication labelling is occurring. The standard set is 80%. The prescription clerk checks random selection of scripts on one day every six months and determines level of indication labelling. A check in January 2004 showed that 89% had indication labelling and in August 2004 100% had indication labelling.

Destination Audit – Primary Care
A visit to a residential home for learning disabled was carried out. The home had six residents of which there were 52 prescribed medicine items. The medicines were delivered by the Boots medicines system. Forty-seven of the drugs had listed indication labelling, which gave coverage of 90%. Examples of unlabelled medicines were nutritional and also paracetamol.