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Improving Medication Safety: Update on the HHS Medication Management System Project Improving Medication Safety: Update on the HHS Medication Management.

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Presentation on theme: "Improving Medication Safety: Update on the HHS Medication Management System Project Improving Medication Safety: Update on the HHS Medication Management."— Presentation transcript:

1 Improving Medication Safety: Update on the HHS Medication Management System Project Improving Medication Safety: Update on the HHS Medication Management System Project Helena Trabulsi, Director of Pharmacy HHS Management Meeting November 11, 2011

2 2 Why Should We Care About This? Incidents involving medications are the second largest category reported at HHS Incidents involving medications are the second largest category reported at HHS Increasing use and complexity of drug therapies Increasing use and complexity of drug therapies HHS Drug inventory = 2,500+ products HHS Drug inventory = 2,500+ products A significant proportion of nursing time is spent on medications A significant proportion of nursing time is spent on medications Current system is many years out of date inefficient, and frustrating for staff Current system is many years out of date inefficient, and frustrating for staff

3 3 Current State Limitations Loose tablets, crowded drawers Loose tablets, crowded drawers Packaging look alikes Packaging look alikes Similar drug names sound alike Similar drug names sound alike Missing information Missing information Legibility of handwriting Legibility of handwriting Manual processes & checks Manual processes & checks Environmental factors Environmental factors

4 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

5 5 Vision for Future – Fully Automated Medication Management Process Prescribing/ Ordering CPOE Medication Ordered 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 Distribution Medication placed in Automated Dispensing Units (ADU) on patient care unit. Administration Nurse validates Orders from eMAR & collects patients medications from ADU Using mobile cart and bedside computing, nurse leverages barcode to verify & administer medication Closing the Loop eMAR is updated & CQI reporting is performed and acted upon

6 6 Unit Dose Packaging with Bar Code

7 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

8 High Speed Unit Dose Packager Team

9 March 2012: BoxPicker High Density Drug Storage Retrieval of Other Forms of Bar Coded Meds Interface to Omnicell ADUs

10 Inside the BoxPicker: Robotic Arm and Containers Filled with Meds

11

12 12 November 2011 to Early ADU Locations across 3 Sites: 55 ADU Locations across 3 Sites: Emergency/Outpatient Dept Emergency/Outpatient Dept Surgical Day Care Surgical Day Care OR/Post-Anaesthetic Care Area OR/Post-Anaesthetic Care Area Obstetrics Obstetrics Medical/Surgical Units Medical/Surgical Units Complex Continuing Care & Rehab Complex Continuing Care & Rehab ICU/COU ICU/COU Hemodialysis Hemodialysis GH (Dec to Feb. 2012) GH (Dec to Feb. 2012) Then OTMH then MDH Then OTMH then MDH

13 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

14 14 Unique Features of ADUs from Multiple towers or cells linked together Access by Biometric I.D. (fingerprint scan) Anywhere RN, Singlepointe, Omniexplorer

15 15 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

16 16 November 2011 to Early 2013 Med Carts Med Carts 1 per 6 to 9 inpatient beds 1 per 6 to 9 inpatient beds Transport meds from ADU to bedside Transport meds from ADU to bedside Investigate alternative solutions Investigate alternative solutions Replace Aging Med Refrigerators Replace Aging Med Refrigerators

17 Electronic Medication Administration Record (eMAR) Electronic Medication Administration Record (eMAR) Computers & Bar Code Scanners on Med Carts Computers & Bar Code Scanners on Med Carts Scan patient wristband, drug, nurse ID Scan patient wristband, drug, nurse ID

18 Project Leadership Project 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

19 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 reqd

20 Safety Expo

21 Implementation Steps Workflow Redesign Standard Operating Procedures Renovations Connectivity, Interfaces Installation Training – eLearning modules plus Live session Conversion/ Go-Live!

22 22 Introducing Technologies for Safe Medication Practices….. ……Safer Patient Care!

23 Handling Instructions for Samples Separate along perforation at right (folded side) Open package from Left (sealed side)


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