A Smaller Carbon Footprint and Reduced Cost: Luton Crisis Team’s Medication Waste QI Project

By Maryam Chohan, Crisis Team Pharmacist

Figure 1: Project team, graduating from the Improvement Leaders Programme. Kirsty Williams (Clinical Lead) – left, Maryam Chohan (CRHT Pharmacist) – centre, Bamidele Bello (CRHT nurse) – right.

Where We Started

In autumn last year (2022) I identified that medication waste was an issue in our team. Medication was regularly being destroyed when it wasn’t being given to our service users on discharge. Destroyed medication is a waste of resources, adds to our team’s carbon footprint, and wastes money. We started our Quality Improvement (QI) project in November 2022, which coincided with the start of the QI Improvement Leaders Programme.

Testing changes

One of the clinical leads and an experienced nurse joined the QI project. We built our driver diagram and agreed on what changes to test first. One of our key primary drivers were around the team’s processes and we agreed this should be our initial focus.

We started with the ‘home visit template’ that staff use when visiting patients’ homes. We amended this to ensure that staff are recording accurately how much medication a patient has, identifying if they are due to run out of medication and to note down if further medication is needed. We also conducted staff training to ensure everyone is aware of the team’s processes and that medication is given when ordered for patients on discharge. Our third change idea was to call or text patients to collect their medication if it was still in the cupboard and not given to them. We started seeing reductions in waste after adapting our template, and following our third change idea, contacting patients to collect their medication, we really saw a drop in our medication waste.

Figure 2: Our driver diagram

Our Waste Reduction and Impact

When we started our project, the Luton crisis team destroyed on average 119 tablets bi-weekly. Following the change ideas we tested and then implemented, on average 4.4 tablets are now wasted bi-weekly.

Figure 3: Numbers of tablets destroyed bi-weekly.

The reduction in the number of tablets destroyed provides an estimated cost saving of £517 per year.

In addition, our reduction in medication waste saves approximately 66.2 kgCO2e per year. To put this into perspective, 66.2 kgCO2e is equivalent to the energy consumption of an average household for about 8 days, or driving about 262 kilometres in an average car.

Sustaining our Success

We are thrilled to have achieved our aim and the impact that has had on our carbon footprint as well as our savings on cost. We will continue to track our medication waste, audit our medication documentation, and have conversations with the senior managers to ensure we sustain our great results.