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Island Health – Implementation of a fully automated Electronic Health Record and Closed Loop Medication System – lessons learned Jan Walker Regional Leader,

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Presentation on theme: "Island Health – Implementation of a fully automated Electronic Health Record and Closed Loop Medication System – lessons learned Jan Walker Regional Leader,"— Presentation transcript:

1 Island Health – Implementation of a fully automated Electronic Health Record and Closed Loop Medication System – lessons learned Jan Walker Regional Leader, Medication Safety Clinical Lead UDMD Project Quality & Patient Safety Russ Swaga Manager Pharmacy Informatics Pharmacy Lead, IHealth The right drug, the right dose, given to the right patient, at the right time…..

2  OHC Services the Oceanside geographic area consisting of approximately 50,000 residents.  Provides urgent care, medical day care, medical imaging, outpatient laboratory, primary care and integrated community care services (mental health, seniors health, home and community care, diabetes and home support)  Center is open from 0730-1030 daily.  Seriously ill clients needing continuing care are referred to one of 3 hospitals close by: Westcoast General, St. Joseph’s General or Nanaimo Regional General hospitals.

3 Medication Errors - Preventable Categories

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5  22million medications are mixed annually  14 million are mixed by nurses  8 million are mixed by pharmacy

6 Systems and Processes to support Medication Error Reduction CPOE – Computerized Provider Order Entry eMAR – Electronic Medication Administration Record ADC – Automated Dispensing Cabinets PPID- Positive Patient Identification (bar code scanning) BBVM – Bedside Barcode Verification of Medications (bar code scanning)

7 Evidence Based Order Sets Dose Range Checking Adverse Drug Event Rules Med Reconciliation Prescribing Transcribing Ordering and Dispensing Administration Documentation Closed Loop Medication System (CLMS)

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13 : Nurse retrieved correct medication, scanned and administered Order for Gravol inj: Nurse scanned diphenhydrAMINE 50 mg/mL Vial – 1 mL (Benadryl) and received a warning

14 : Nurse scanned tetanus imm.glob.hum. 250 unit syr -1 mL for the order below and received an alert, prompting her to realize it was the wrong vaccine..

15  Education is key  Physician engagement is key  Timely order entry is key  All professionals working within scope is key  Appropriate staffing levels is key  Understanding workload and workflow is key  Computer login lag is a determinant  Non Scannable Medications is a determinant  Leadership turnovers early in adoption phase is a determinant

16  Engage end users as early in the design process as possible  Ensure all stakeholders are involved ◦ Nursing, Pharmacy, Quality and Safety (MedSafety), Informatics, and I.T.  Factor in ongoing support and maintenance into Project Plan  After stabilization, have an auditing and metrics plan in place that is tied to a Continuous Quality Improvement (CQI) strategy

17  Implementation of a fully electronic health record, throughout acute and residential services within Island Health ◦ One patient – One record wherever possible within the organization  A fully functional closed loop medication administration system throughout acute and residential services within Island Health ◦ Safer medication practices to enhance safe patient care and reduced medication error incidents

18 A vision needs people – the right people!


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