A plethora of written patient information accompanies medicines dispensed (TTOs) for patients discharged from an independent Hospice inpatient unit. This includes:

• Manufacturer’s patient information leaflets (PILs) for each medicine used within license - legally required.

• Locally developed PILs for medicines that are unlicensed or for use off-label.

• Green (regular) and blue (when necessary) ‘Drug Information Cards’ listing all medicines and dosage information electronically transposed from the TTO prescription.

• Locally developed PILs informing about medicine groups warranting special care in use e.g. ‘morphine and other opioid painkillers for moderate to severe pain’.

It was observed that this ‘jumble’ of leaflets and medicines looked disorderly and unprofessional, with a real risk of information being lost, overlooked or simply discarded as unimportant. The aim was to develop how written patient information was presented to patients and carers in a way that was:

• Professional and distinctly noticeable.

• Neat, orderly and clear.

This problem was presented to the hospice Medicines Management Group (MMG) for resolution. The MMG is a multidisciplinary team comprising of medical, nursing and pharmacy representation with roles including the continuously improvement of the quality of pharmaceutical related practice and processes, often in an innovative way. They developed the following solution:

• ‘Hospice branded’ A4 front and rear cover, cardboard folder with rear cover hole punched near spine.

• Flat bar file fastener fitted to the rear page to hold:

  • Explanatory page.

  • A4 unlicensed PILs.

  • A4 Drug Information Cards.

  • An A4 plastic pouch holding the manufacturers PILs (variable sizes)

• The completed file is then placed in the bag containing TTOs.

This solution has potential for application in other settings.