San Antonio, Texas-based University Health faces a number of medication management challenges that can impact both effectiveness and patient safety.
PROBLEM
As a large and ever-expanding health system – including a Level I trauma center, retail pharmacies and specialty pharmacies – it recognized the need to optimize its drug delivery process .
Nurses often spend too much time searching for medications in the dispensing cabinet, a task akin to playing a game of “Where’s Waldo” due to the disorganization and movement of items in the matrix drawers. With 150,000 drug dispenser transactions per month, this wastes a significant amount of nurse time that could be better spent on patient care.
Furthermore, the matrix drawers themselves also cause problems. Medicines can move around in drawers, leading to lost or expired medicines, and there are even cases where medicines are crushed or spilled, leading to contamination and waste.
These issues threaten to compromise drug integrity and availability, while creating additional work for staff on cleaning up and managing discrepancies. Jennifer Hillman, director of pharmacy operations at University Health In Patient Pharmacy, said this system is simply not sustainable for a health system of this size and care teams with increasing needs having to balance. She has a doctorate in pharmacy.
PROPOSE
“The recommended solution from the vendor we selected addressed these challenges with a number of security and workflow features designed to streamline management,” she explains. medicine and improve patient safety. “We are looking at a combination of hardware and software tools that promise to save nurses time while also making it easier to manage medications across our health system.
“This focuses on enhancements to the dispensing cabinet, connected software to improve visibility and support for remote workflows, and workflow features,” she continued. work is simplified”.
Key components include lidded, locking metal bins to replace problematic matrix drawers. These bins ensure medications remain in place, preventing migration and subsequent problems such as lost or expired medications.
“By maintaining medication integrity and organization, this solution is expected to significantly reduce the time nurses spend at the cabinet and minimize medication waste and contamination,” Hillman noted.
“Another important feature is the controlled single-substance dose dispenser, which is specifically designed for a variety of dosage forms, including tablets, capsules, syringes and vials,” she said. “These dispensers are designed to dispense only the exact amount of medication required, thereby reducing the possibility of bias and ensuring more accurate dispensing.”
The promise of this technology caught Hillman’s attention when University Health had more than 15,000 controlled substance transactions each month, which created many opportunities for costly drug mishaps or waste.
“When thinking about nursing workflows, one promising feature will be allowing nurses to line up for medications from their workstation instead of having to go to the medicine cabinet, helping to reduce congestion and wait times.” Wait at the medicine dispenser,” she said.
“At the simplest level, these new cabinets also have special lighting features that help guide our nurses to the location of the medications they need,” she continued. “Even though it may seem like the smallest feature, it’s amazing to see the impact it has on nurses’ office time.”
These features promise to increase operational efficiency, improve medication management and enhance patient safety, she added.
MEETING THE CHALLENGE
As a health system, University Health is focused on fully understanding how the technology it delivers works. Hillman often says that although a health system is as big as the Titanic, it needs to be as nimble as a jet ski to ensure it can always provide appropriate care to patients.
“This is especially important in medication management,” she notes. “When we first switched to Omnicell, we converted 207 dispensing cabinets across our health system in just eight weeks. These cabinets were fully integrated into our IT, EHR, and control systems. prescribe medications, with one server managing connections across our healthcare system.
“This integration enables real-time updates and tracking of medication usage, further enhancing our ability to effectively monitor and manage inventory,” she continued. “The combined functionality of the Omnicell system and our EHR ensures our medication administration process is efficient, safe and aligned with the overall goal of patient safety.”
The primary users of this technology are nursing staff and pharmacy technicians. Nurses have already realized the promised benefits from the indicator system, which highlights the exact location of needed medications, significantly reducing search time in cabinets. The RN Anywhere feature allows them to queue medications from their workstation, reducing cabinet congestion during peak periods.
“Pharmacy technicians play a vital role in maintaining the system,” Hillman explains. “They are responsible for storing locked, covered metal containers, ensuring each container contains the correct medication and that they are stored securely. Controlled single-substance dispensers are also managed by technicians, who ensure they are filled correctly and operate correctly to dispense the correct dose, minimizing discrepancies.”
RESULT
One of the most important results was a significant 50% reduction in nurse-made variations in the medicine cabinet. This improvement is largely due to the controlled single-agent dose dispenser, which ensures nurses receive exactly the amount of medication needed, minimizing the potential for errors.
“While this is a significant win from a safety perspective, it also shows how we can reduce the manual burden on nurses in managing counters at the cabinet,” Hillman reports. in the context of an already busy working day. “We can also reduce the administrative burden on our pharmacy technicians of having to investigate all of these discrepancies, allowing them to focus on other important tasks.
“Another key success indicator was a 20% reduction in the time nurses spent in the medication dispenser,” she said. “The pick-to-light system played a key role in this achievement by streamlining the medication pick-up process.”
Nurses no longer have to line up in front of cabinets or spend too much time searching for medications, which means more time for higher-value patient care tasks. This efficiency enhancement is critical, especially during busy medication transfer times.
“Additionally, converting to locked, lidded metal bins increased our floor storage capacity by 30 percent,” Hillman reports. “This increased capacity means we no longer have to regularly discard drugs to make room for new ones, simplifying inventory management and reducing the likelihood of drugs going missing or going missing.
“The integrity and overall organization of our medication storage system has been significantly improved, contributing to better inventory control and reduced waste,” she said.
ADVICE TO OTHERS
Technology-driven medication management is no longer optional for hospitals – replacing manual workflows with automation for frontline teams not only improves efficiency but is key to patient safety, Hillman advises.
“The decision is not just about features and functionality but also the partnership the vendor can offer,” she said. “Technology integration is critical to maintaining accurate and real-time medication inventory and usage tracking, which helps prevent errors and streamline workflows. But I also recommend Find a vendor that is committed to working with you to resolve any hiccups that will inevitably arise during implementation.
“Another important consideration is staff engagement and training,” she continued. “The success of new technology depends greatly on how well users, especially nurses and pharmacy technicians, understand and use the system.”
Investing in comprehensive training and cultivating a culture of continuous improvement can significantly enhance the effectiveness of technology, she added. Involve employees early in the decision-making process and incorporate their feedback to tailor the system to meet the organization’s specific needs, she says.
“Ultimately, it is important to evaluate the scalability and adaptability of the technology,” she advises. “The healthcare environment is dynamic, with changing needs and growing patient populations. Choosing a system that can scale and adapt to these changes without requiring an extensive overhaul will ensure long-term success and return on investment.
“Look for technology partners that are committed to innovation and ongoing support, as this collaboration will be invaluable in addressing future challenges and opportunities,” she concludes.
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