Transcript A System to Improve Medication Safety in the Setting of

INTRODUCTION
Medication Management Process Surveillance
Vanderbilt University Medical Center has
accumulated a critical mass of inpatient clinical
Inpatient Clinical
information systems that can be used to influence
health care delivery and resulting data may
inform us about clinical processes. The
Information Systems,
Obtain
Medicationrelated History
Document
Medication
History
Diagnostic/
Therapeutic
Decisions
Made
collaborators design, operate, and analyze such
CURRENT SYSTEMS/RESOURCES
Medication Inventory Management
Ordering
WizOrder/Horizon Clinicals team and its
WizOrder/Horizon Expert Orders
FCG, VHA Inc. after Bates et al. JAMA 1995
Kilbridge 2005
Pre-admit Medication list
systems.
Decision Support,
Surveillance monitors all stages in Medication
Management Process
History-Taking
Medication
Ordered
Formulary,
purchasing
decisions
Order verified
and submitted
Inventory
management
ConnectRx Carosel
CPOE
Surveillance
Pharmacy Management
Evaluate order
Monitoring and
Surveillance
Select
medication
Dispense/
distribute
medication
Prepare
medication
HMM Pharmacy System
and Analysis
Administration Management
Monitor/Evaluate Response
Intervene as
indicated for
adverse
reaction/error
Assess and
document
patient
response
to medication
according to
defined
parameters
Document
Document
administration
and associated
information
Administer Medication
Administer
according to
order and
standards for
drug
Select the
correct drug for
the correct
patient
Education
Educate
patient
regarding
medication
Educate staff
regarding
medications
Bar code admin; eMAR; smart IV pumps, Discharge Med Reconcilation
Russ Waitman, PhD
Medication Reconciliation
Collaborators:
Asli Ozdas, PhD
PROJECTS
1. Leverage improvements in microbiology
Horizon Expert Documentation
systems to enhance antimicrobial stewardship
2. Quantify the hospital’s medication
Josh Peterson, MD, MPH
administration performance with BCMA data
Jack Starmer, MD
3. Enhance medication reconciliation with
codification via RxNorm
Randolph Miller, MD
4. Streamline discharge and transfer processes
Department of Biomedical Informatics
5. Conduct knowledge discovery on inpatient
Vanderbilt University Medical Center
data linked to mortality by incorporating Social
OBJECTIVE:
Develop content driven Clinical
Information Systems that provide rich
decision support. Use clinical
information systems as a vehicle for
improving patient care in the context
of larger health care process changes.
Harvest and analyze the resulting data
to better understand healthcare
delivery, disease processes, and
optimize therapy.
Security Death Index data. Investigate newer
database technologies for clinical data mart.
Adverse Drug Event Surveillance
6. Evaluate the impact of inpatient/outpatient
allergy integration
7. Enhance Alerting/Task list tools for nursing.
8. Continuous protocol evaluation: are nurse
OTHER RESOURCES/SYSTEMS
Content Management tools and databases
(orderables, ordersets, drug decision
support, advisors); Barcoded medication
administration (BCMA), AdminRx; Data mart
of order transactions, user keystroke logs,
lab results; CareOrganizer/STAT interfaces
managed heparin and insulin optimizing care?
9. Build systems to monitor drug decision
support effectiveness; build new approaches
that suggest personalized alternatives.
10. New sources for decision support: create a
Vital Signs Repository with q30second data and
integrate with perioperative systems
© VANDERBILT UNIVERSITY 2008