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Background The Mildred Creak Unit (MCU) is a children’s inpatient unit which is traditionally staffed by 3 prescribing doctors. The TTA prescribing practice is dynamic, and has traditionally relied on nursing team liasing with parents on a weekly basis, and communicating the required medication orders to doctors via various channels of communication. With no centralised record, this has led to duplicate requests and prescribing errors, as well as inefficient communication.Aims Improve efficiency and reduce errors related to TTA prescribing practices. We hypothesize that the lack of a centralised TTA record for the MCU is a significant cause of inefficient use of clinician/nursing time and contributes to errors in prescriptions for TTA medication.Methods We identified three primary drivers: prescribing errors, inefficiency in communication and additional clinical time. Secondary drivers included: lack of centralised system for recording TTA requests/prescriptions; communication via multiple formats; and extra time required to check orders/requests to avoid duplication. Change ideas included: creation of a centralised record of all TTA requests/completed prescriptions. Baseline data was repeated following implementation of change ideas.Results Data collected following implementation of change ideas showed a percentage reduction across all categories over a 2 week sample period (20/01/25 – 31/01/25), as compared to preliminary data (collected over a corresponding sample period, 29/10/24 – 8/11/24). The amount doctors were contacted via EPIC chat reduced by 75%, contact via telephone reduced by 40%, contact in conversation reduced by 83%, and the amount TTA orders were brought up in morning huddle reduced by 50%. Medication prescribing errors, reflected by DATIX completed, reduced by 100%.Conclusions A centralised record for TTA prescriptions on the MCU has demonstrated improved efficiency and a reduction in wasted clinician time. There was also a clear reduction in prescribing errors, which has important implications for improved patient satisfaction and safety.