The Medication Management Council is a thought leadership initiative of Omnicell whose mission is to identify ways to improve medication management processes across the industry, leading to better outcomes for healthcare stakeholders. In January 2015, the Council produced the first of its three lists planned for the year, Top 10 Safety Best Practices. In August, the Council announced its second best practice list: Top 10 Efficiency Best Practices.
The Medication Management Council comprises industry, pharmacy and nursing professionals from healthcare provider organizations and academic institutions. Some 20 best practices in the area of efficiency were researched, analyzed, proposed, discussed, and voted on by the Council members. Hospitals and health systems are encouraged to use the efficiency best practice list to quickly assess their own medication practices and determine areas of improvement on which to focus.
Top 10 Efficiency Best Practices for Medication Management
1) Integrate retail pharmacy databases with the hospital electronic health record.
Description: There should be some form of data sharing between retail pharmacy databases and the hospital electronic health record or a single integrated system combining them in order to create a patient compliance dashboard and a scoring mechanism to identify non-compliance and allow pharmacist follow-up with non-compliant patients.
2) Apply inventory control management systems to all areas where medications are stocked.
Description: All areas that have medications permanently stored should have an inventory system in place for monitoring and control, including tracking all movement of inventory in and out of the area. The system should provide: 1) a method to identify inventory across the healthcare system; 2) a single dashboard allowing inventory visibility across the entire system (incorporating data from automated dispensing cabinets and central pharmacy systems); 3) optimization of inventory levels and reorder points; and 4) creation of automated replenishment orders for all areas.
3) Store all stocked medications in secure, individual compartments, and store patient-specific medications in patient-specific bins within automated dispensing cabinets and automated dispensing cabinet refrigerators.
Description: By allowing nurses to quickly locate medications on the floor or unit, automated dispensing cabinets enable an organized workflow and increase the efficiency of medication administration. Efficiency is further enhanced by having designated areas in automated dispensing cabinets for common stock medications and patient-specific medications, as well as a cabinet system in refrigerators.
4) Maximize the use of barcode technology in medication distribution, from receipt through administration.
Description: Upon delivery, medications should be scanned to capture relevant data (NDC, lot number, expiration date, etc.). The barcode should include data regarding compounding or distribution to locations outside the hospital pharmacy, which eliminates the need for manual verification by pharmacy staff and increases the safety of medication transfers.
5) Optimize delivery of medications based on current patient needs.
Description: Inpatient and outpatient patient procedure schedules should be coordinated with the inventory levels of automated dispensing cabinets to enable a more efficient delivery schedule that factors in the location of cabinets.
6) Standardize code carts to improve medication visibility, organization, and grouping.
Description: The human factors principles of improving medication visibility, organization, and grouping should be applied to create an efficient code cart, which results in faster completion and fewer wasteful actions during a code, improved medication management, and enhanced patient safety.
7) Equip automated dispensing cabinets with an automatically updated complete database of manufacturer barcodes in the system.
Description: The American Society of Health-System Pharmacists recommends that drug manufacturers provide barcodes with NDC, lot number, and expiration date on all unit-dose product packages and that barcode technology be used in each significant step of the medication-use process.
8) Equip automated dispensing cabinets with systems for system administrators and other users that track turnaround time and metrics related to medication dispensing.
Description: All medication dispensing and administration systems, including automated dispensing cabinets, should feature a single user interface for tracking efficiency metrics, which allows pharmacy staff to identify weaknesses and areas for adjustment in medication dispensing workflows.
9) Use technology to monitor drug use, misuse, noncompliance, and adverse drug events on a real-time basis.
Description: Healthcare information technology should be used to monitor prescription drug use on a real-time basis to identify misuse (overdose or subtherapeutic administration) of medications, drug diversion, noncompliance with medication administration, and potential adverse drug events.
10) Retrieve IV medication administration information directly from the medication administration record of the patient.
Description: Nurses currently have to press a number of buttons to initiate an IV and use drug libraries within the IV pump. IV infusion pump integration with the electronic health record should expedite the process by enabling the following: 1) the nurse scans the patient; 2) the nurse scans the medication; 3) the IV pump is associated with the medication; 4) information is sent from the medication administration record to the IV pump; 5) the IV pump sends information back to the electronic health record once the infusion is complete, along with the stop time; and 6) the nurse validates all information in the electronic health record and completes the transaction.
Let us know if you have other suggestions for improving efficiency or want to suggest other topics related to medication management that the Medication Management Council should look into. The next list the Council plans to tackle is best practices for compliance.
Read our post on the Top 10 Safety Best Practices