Improving Medication Safety: Update on the HHS Medication Management System Project Improving...
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Transcript of Improving Medication Safety: Update on the HHS Medication Management System Project Improving...
Improving Medication Safety:
Update on the HHS Medication Management System Project
Helena Trabulsi, Director of PharmacyHHS Management MeetingNovember 11, 2011
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Why Should We Care About This?
Incidents involving medications are the second largest category reported at HHS
Increasing use and complexity of drug therapies
HHS Drug inventory = 2,500+ products
A significant proportion of nursing time is spent on medications
Current system is many years ‘out of date’ inefficient, and frustrating for staff
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Current State Limitations Loose tablets, crowded drawers Packaging ‘look alikes’ Similar drug names ‘sound alike’ Missing information Legibility of handwriting Manual processes & checks Environmental factors
New Medication Management System Benefits
Enhanced patient safety Accuracy of medication system Efficiency of drug distribution system Tracking of drug utilization & costs Improved customer service Increased job satisfaction
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Vision for Future – Fully Automated Medication Management Process
Prescribing/Ordering
CPOEMedicationOrdered
Pharmacy-based therapeutic checking & order verification
Medication Orders update the eMAR
Unit-dose bar-coded medications ordered from distributor or bulk meds packaged. Pre-mixed IV solutions purchased and prepared.
Preparation
DistributionMedication
placed in Automated Dispensing Units (ADU) on patient care unit.
Administration
Nurse validates Orders from eMAR & collects patient’s medications from ADU
Using mobile cart and bedside computing, nurse leverages barcode to verify & administer medication
Closing the LoopeMAR is updated & CQI reporting is performed and acted upon
High Speed Unit Dose Packager (“ATP”) Installed at Oakville
Pharmacy Nov. 1, 2011
Output = tablet or capsule packaged as a unit dose with a bar code
High Speed Unit Dose Packager Team
March 2012: “BoxPicker” • High Density Drug Storage
• Retrieval of Other Forms of Bar Coded Meds
• Interface to Omnicell ADUs
Inside the BoxPicker: Robotic Arm and
Containers Filled with Meds
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November 2011 to Early 2013 55 ADU Locations across 3 Sites:
Emergency/Outpatient Dept Surgical Day Care OR/Post-Anaesthetic Care Area Obstetrics Medical/Surgical Units Complex Continuing Care & Rehab ICU/COU Hemodialysis
GH (Dec. 2011 to Feb. 2012) Then OTMH then MDH
Benefits of ADUs Improved Safety
Guides nurse to the drugs that are ordered for the patient
‘Look-alike’ & ‘sound-alike’ stored apart Bar Code scan on Pharmacy restock
Improved Efficiency Quicker access to drugs
At point of use After Pharmacy closed
Improves narcotic management Decreases narcotic counts Decreases narcotic discrepancies
More time to spend with patients Increased job satisfaction
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Unique Features of ADUs from
• Multiple towers or “cells” linked together
• Access by Biometric I.D. (fingerprint scan)
• Anywhere RN, Singlepointe, Omniexplorer
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Unique Features of ADUs from
• Drawers with lights to guide user to specific compartment/bin
• Drop-down “dispensers”• Lidded Sensing Bins, Locked
Bins• Fridge Locks
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November 2011 to Early 2013
Med Carts 1 per 6 to 9 inpatient beds Transport meds from ADU to bedside Investigate alternative solutions
Replace Aging Med Refrigerators
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2013-14 Electronic Medication Administration Record (eMAR)
Computers & Bar Code Scanners on Med Carts
Scan patient wristband, drug, nurse ID
Project LeadershipProject Sponsor
Sylvia Rodgers – Chief Nursing Officer & Professional Practice Leader
Functional Department Lead Helena Trabulsi – Director Pharmacy
Project Manager Diane Olmstead, PMP
Advisory Group Medication Safety Committee
Reporting Structure To the Chief Nursing Officer and To the Medication Management Steering Committee Quarterly (or more often) updates to the HHS Board and
Senior Management
Team & Advisory Members Nursing:
Angela Roode - PPC, Safe Med Practices Nursing Super Users – TBD Patient Care Managers – As each site/unit rolled
out
Pharmacy: Nicky Hillebrand, Katrina Stasik, Grace White -
Managers Marie Descent, Boris Curcic, Janice Mack –
Pharmacy Analysts Pharmacy Technician & Assistant Super Users
Clinical Informatics: Elaine Hooper – Manager of Clinical Informatics Veronica Breadner – Clinical Analyst
Vendor Project Managers: Omnicell – Dave Burleson, Maggie Wagner Swisslog – Tony Schrader, Cindy Doig (Consultant)
Redevelopment – Jim Agnew
Medication Management Experts (Consultants)– TBD
IT Network and Technical Resource – as req’d
Safety Expo
Implementation Steps
Workflow Redesign Standard Operating Procedures Renovations Connectivity, Interfaces Installation Training – eLearning modules plus Live
session Conversion/ Go-Live!
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Introducing Technologies for Safe Medication Practices…..
……Safer Patient Care!
Handling Instructions for “Samples”
Separate along perforation at right
(folded side)
Open package from Left (sealed side)