Our Solutions


Our Solutions

Guidance MS®

Guidance MS is a network-wide solution for managing clinical guidelines and drug stewardship. It provides role-based functionality for medical staff, pharmacists, senior prescribers and stewardship program managers. It is widely used by hospitals to manage drug formularies and to triage patients on high-risk drugs or who have serious conditions needing specialist review. It can be implemented as a standalone system or integrated with other clinical IT systems such as Patient Management, User Security and ePrescribing. 

Guidance MS is the only electronic stewardship tool in Australia with independent evaluation in peer-reviewed international publications. A 2008 Journal of Antimicrobial Chemotherapy article demonstrated positive impacts of this system, with reported gradients in the prescribing of third- and fourth-generation cephalosporins, glycopeptides, carbapenems, aminoglycosides and quinolones all decreasing after Guidance MS implementation. Trends in increased susceptibility of Staphylococcus aureus to methicillin and improved susceptibility of Pseudomonas species and no increase in adverse outcomes for patients with Gram-negative bacteraemia were observed. 

Guidance MS is now well established with proven sustainability and subsequently has been implemented within more than 60 sites nationally. Furthermore, a 2017 Journal of Antimicrobial Chemotherapy article demonstrated the transferability and ongoing efficacy of this system in a networked environment. It was reported that through a centrally-deployed clinical decision support service, there was a demonstrated decrease in antimicrobial costs, decrease in Clostridium difficile rates and no observable change in length of stay or mortality. 
Since 2013, AMS has been a hospital accreditation standard and every Australian facility is expected to be monitoring and improving their use of antimicrobials. Pre-prescription review and approval has been an effective and rapidly implementable process that is often the cornerstone of AMS programs, being able to fit well into the workflow of hospital systems. When it was first developed and released, the initial, simple system had decision support directed to electronic clinical guidelines and a pre-prescription approval system.

From the recent 2017 Clinical Infectious Diseases article, it is evident that post-prescription review with feedback had a greater impact on days of therapy for antibiotic use than pre-prescription authorisation with no change in clinical outcomes. Guidance MS has long enabled post-prescription review via its alerts workflow. This tool has now matured to formally include a post-prescription review module as part of its new release. 
  • Buising KL, Thursky KA, Robertson MB, et al. Electronic antibiotic stewardship--reduced consumption of broad-spectrum antibiotics using a computerized antimicrobial approval system in a hospital setting, J Antimicrob Chemother 2008, 62(3):608-16.
  • Bond, SE, Chubaty, AJ, Adhikari, S, Miyakis, S, Boutlis, CS, Yeo, WW, ... & Li-Yan Hui, S 2017, 'Outcomes of multisite antimicrobial stewardship programme implementation with a shared clinical decision support system', J Antimicrob Chemother, 72(7): 2110-2118.
  • Tamma PD, Avdic E, Keenan JF, et al. What Is the More Effective Antibiotic Stewardship Intervention: Preprescription Authorization or Postprescription Review With Feedback? Clin Infect Dis 2017; 64 (5): 537-543. 
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Guidance Post-Prescription Review Tool

The Guidance Post-Prescription Review (GPPR) tool is a new clinical workflow tool for AMS teams. It is able to be seamlessly integrated with Guidance MS, allowing the AMS team to generate ward round lists, manage approvals during these rounds, and document patient assessments and recommendations, including uptake of these recommendations. The GPPR tool can be integrated with other approval systems, and electronic medication management and pharmacy dispensing systems to maximise the oversight of all antimicrobials, both restricted and unrestricted. The tool is then able to provide detailed reports for quality improvement exercises and feedback to units about their prescribing practices. 

Benefits:

Seamless integration with Guidance MS.
Easy to implement (IT and clinical). 
Meets reporting requirements.
Measure and report the outcomes of AMS in real time:
  • activities and workload;
  • significance of interventions; and
  • acceptance of interventions.
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Pharmacy Dispensing System integration 

Integrating Guidance MS with your hospital pharmacy dispensing systems will enable these to automatically trigger pharmacy alerts when dispensing restricted antimicrobials without an approval, adding these to the AMS team’s review list. This will alleviate the need for pharmacists to create alerts and free up their time for other duties, while allowing the increased capture rates of restricted antimicrobials for potential post-prescription review and interventions.

Benefits:

Automatic capturing of antimicrobials dispensed without approval during:
  • initial therapy; and
  • continuous / extended therapy.
Reduce pharmacist manual interaction, which:
  • saves pharmacist time; 
  • increases coverage; and 
  • allows more opportunities for AMS team post-prescription reviews. 

Electronic Medication Management System integration

Having Guidance MS as part your hospital information technology system will ensure you are ready for seamless integration of data from pre-prescription approvals through to post-prescription review, enabling all the benefits of its reporting functionality. Guidance MS is ready for electronic medication management system integration. It has been successfully integrated with Cerner® at 3 sites and is currently being deployed to others, facilitating future integration with other electronic management systems as required. With such integration there will be reduced need for duplication of data entry by prescribers, when approvals are required. 

Benefits:

No separate login to Guidance MS.
No duplicate step of patient and antimicrobial selection. 
Automatic capture of antimicrobial orders without a valid approval for:
  • initial therapy;
  • continuous / extended therapy.
Reduction of pharmacist manual interaction, which:
  • saves time; and
  • enables staff see more patients. 
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The National Antimicrobial Prescribing Survey

The National Antimicrobial Prescribing Survey (NAPS) is a standardised auditing tool that is designed to assist healthcare facilities to assess the quantity and quality of local antimicrobial prescribing. Development and implementation of the NAPS has been an ongoing collaborative partnership between the National Centre for Antimicrobial Stewardship (NCAS) and the Australian Commission on Safety and Quality in Health Care since 2013. The NAPS is a program partner of the Commission's Antimicrobial Usage and Resistance in Australia (AURA) Surveillance System. The NAPS is administered and delivered by the Guidance Group.

Since the introduction of the Hospital NAPS in 2011, the NAPS suite of auditing programs has grown and diversified to provide tools that support the AMS workforce and meet the challenges of the diverse range of healthcare settings relating to antimicrobial prescribing. There are currently 4 electronic modules available: Hospital NAPS, Surgical NAPS, Quality Improvement NAPS and Aged Care NAPS. The latest audit tool currently in its pilot stage is the Hospital in the Home (HITH) NAPS, and in the early development stages are the Veterinary NAPS and General Practice NAPS
The NAPS has become an important tool in the implementation of the objectives of Australia’s National Antimicrobial Resistance Strategy relating to appropriate and judicious use of antimicrobials. It does this by:
  • facilitating effective audit and review of antimicrobial use, including compliance with prescribing guidelines and prescribing appropriateness;
  • facilitating effective communication about antimicrobial use and identifying key areas of concern;
  • supporting education and training of the workforce;
  • supporting implementation of AMS practices across all health care facilities; and
  • providing flexible and useful benchmarking within facilities and between facilities, jurisdictions and national data.
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iPolicy®

iPolicy is a comprehensive web-based system for managing policies, procedures and guidelines. It has been specifically designed to meet the needs of staff working in the hospital environment. For general users, it provides an easy-to-use, visual tool for finding documents that are appropriately categorised. Department managers are able to manage the end-to-end approval process for a particular document, see how often documents are accessed, and generate instant reports for committees. 

Hospital executives are able to monitor which policies have been read by staff and which ones have expired.The system has been well embedded at The Royal Melbourne Hospital and Peter MacCallum Cancer Centre in Melbourne.
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Guidance DS®

Guidance DS is a web-based approval system that facilitates antimicrobial stewardship in hospitals. It is designed to work effectively to provide the functionality necessary to meet the day-to-day workflow of junior and expert prescribers. It does not have the multi-site approval capability of Guidance MS and is best suited to hospitals that are looking for standalone solutions. It was first implemented in the state of Victoria, Australia, in 2005. 


Organise a demonstration

The best way to understand how Guidance solutions can transform your stewardship program is to see them in action. 
Organise a demonstration with us and we can take you through how these tools work. 

Organise a Demonstration

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