Pharmacy Automation: Bothwell Regional Health Center Improves Patient Safety, Efficiency and Inventory Control
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The Challenge
Outdated pharmacy processes caused two main problems for Bothwell Regional Health Center:
- Inefficiency - Nurses dealt with three-day fills of medications and turnaround time on stat medication orders was too long.
- Inventory control - Tracking narcotics was time consuming and difficult. Bothwell pharmacy director Brad Nicholson kept a running inventory; but on the floors, medication management was out of pharmacy's control.
When Amerinet supplier Omnicell presented a customized, cost-efficient system to streamline medication management and make it error proof, Bothwell signed on.
"The problem was gigantic," says Nicholson. "There was no way to quantify how much stock was lost. Nursing and anesthesia bore the brunt of the inefficiencies, with nurses curtailing patient contact to fulfill pharmacy functions and anesthesiologists sometimes caught in urgent need of fluids or medications.
"I asked Omnicell to tie these processes up and give me a complete solution in the hospital with real equipment and solutions and not vaporware. I wanted a complete assessment of what we needed and when and how they could do it," Nicholson said.
The Solution
Bothwell requested an automated system that would improve patient safety, efficiency and inventory control.
Bothwell asked Omnicell to:
- Reduce the chance for medication error;
- Make medications readily and appropriately available;
- Improve inventory control;
- Reduce consumption;
- Streamline workflow;
- Return control of medication management to the pharmacy department;
- Deliver an automation solution for safety, efficiency and cost savings;
- Customize the system for users - the pharmacy department and nurses;
- Provide training; and
- Manage installation and start-up.
Omnicell worked with Bothwell's staff to establish requirements and design and implement a fully automated system. Omnicell's up-front assessment was key to the success of the process automation. It identified needs and projected areas of cost savings.
Ultimately, Bothwell implemented two Omnicell systems - OmniRX with OmniSupplier Color Touch medication cabinets and OmniLinksRx physician order management.
OmniRx and OmniSupplier Color Touch Medication Cabinets
Eliminating a cart-and-messenger system, Bothwell now houses and catalogs 95 percent of all drugs in automated OmniRx and OmniSupplier Color Touch cabinets on nursing floors and in patient care areas. That means medication is available as soon as an order is approved. Bothwell pharmacists, in tandem with Omnicell, organized the drawers for correct and timely access by authorized nurses and anesthetists.
The pharmacy department monitors medication use, changes in prescriptions and inventory using an Internet site. Orders are filled, approved and released through an easy-to-use touch-screen monitor. Nurses use the station to access patient medications and patient information. If there is a problem in the system, nurses or pharmacists can call a 24-hour service number, and a service technician is instantly dispatched.
OmniLinkRx - Physician Order Management
OmniLinkRx physician order management software provides a digitized view of a physician's handwritten medication order via a Web browser. Nurses fax or scan the order, and the image is instantly available to pharmacists, who verify the order and electronically release the medication to the Omnicell cabinet on the nursing floor. The whole process takes five to 20 minutes versus the two- to three-hour turnaround before automation.
Training
Nicholson and two Bothwell system administrators were trained on the automation system at an Omnicell site in Illinois, and an Omnicell project manager did in-hospital training on the system with every nurse.
Outcomes
By involving all stakeholders at Bothwell, Omnicell designed and implemented a pharmacy automation system that improved patient safety, dramatically increased efficiency and streamlined inventory control.Improved Safety
- Greatly reduced chance for medication error;
- Improved security including narcotic storage and inventory; and
- Increased access by nurses to prescription and patient information.
Increased Efficiency
- Better control of medication processes;
- Improved operational efficiencies;
- Faster turnaround time of first doses - reduced from two to three hours to five to 20 minutes;
- Reduced turnaround time for changes in strength of medication;
- Increased nursing time for patient contact;
- Real-time electronic transmission of physician orders in a legible format; and
- Web-enabled medication location system for authorized users.
Streamlined Inventory Control
- Reduced consumption;
- Adequate floor stock of commonly used medications;
- Usage history recorded; and
- Control of medication management processes returned to the pharmacy department.
Conclusion
Medication management process change was a big commitment for Bothwell Regional Health Center, involving every department in the hospital, from IS to nursing to maintenance to purchasing. The payoff is better control of the medication processes - with greatly reduced chance of medication error and significant efficiency improvements throughout the facility.
"Omnicell delivered on everything they promised and are still working very closely with us," says Nicholson. "The process is a team experience. Adjustments for everyone have been challenging; however, caring professionals can work through all issues. Omnicell made promises and delivered. That made the process much easier."
