Transcript Medication Management - Home

Improving Medication Safety:
Update on the HHS Medication
Management System Project
Helena Trabulsi, Director of Pharmacy
HHS Management Meeting
November 11, 2011
Why Should We Care About This?
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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Current system is many years ‘out of date’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
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Packaging ‘look alikes’
Similar drug names ‘sound alike’
Missing information
Legibility of handwriting
Manual processes & checks
Environmental factors
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New Medication Management
System Benefits
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Enhanced patient safety
Accuracy of medication system
Efficiency of drug distribution system
Tracking of drug utilization & costs
Improved customer service
Increased job satisfaction
Vision for Future – Fully Automated
Medication Management Process
Prescribing/
Ordering
Pharmacy-based
therapeutic
checking & order
verification
CPOE
Medication
Ordered
Preparation
Medication
Orders update
the eMAR
Distribution
Unit-dose barcoded
medications
ordered from
distributor or bulk
meds packaged.
Pre-mixed IV
solutions
purchased and
prepared.
Medication
placed in
Automated
Dispensing
Units (ADU)
on patient
care unit.
Administration
Closing the Loop
eMAR is updated & CQI
reporting is performed
and acted upon
Using mobile cart
and bedside
computing, nurse
leverages barcode
to verify &
administer
medication
Nurse validates
Orders from
eMAR & collects
patient’s
medications
from ADU
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“Unit Dose” Packaging with Bar
Code
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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
November 2011 to Early 2013
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55 ADU Locations across 3 Sites:
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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
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Benefits of ADUs
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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
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Improved Efficiency
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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
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
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Med Carts
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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
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Project Leadership
Project Sponsor
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Sylvia Rodgers – Chief Nursing Officer & Professional Practice
Leader
Functional Department Lead
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Helena Trabulsi – Director Pharmacy
Project Manager
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Diane Olmstead, PMP
Advisory Group
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Medication Safety Committee
Reporting Structure
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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
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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)
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Redevelopment – Jim Agnew
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Medication Management Experts (Consultants)– TBD
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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!
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Handling Instructions for “Samples”
Open
package
from Left
(sealed side)
Separate along
perforation at
right
(folded side)