The Medication Management Council is a thought leadership initiative of Omnicell. Formed in June 2014, the Council’s mission is to identify medication management best practices and generate top 10 lists of best practices in the areas of safety, efficiency and compliance.
Last January, we posted the Medication Management Council’s Top 10 Compliance Best Practices for 2016. The Council has updated its list for 2017, which is presented below. We have noted the recommendation’s rating for last year or designated it as being new for 2017.
1) Surveillance programs should be used to monitor fraud, waste, and abuse of all medications with abuse potential. (New)
Description: Comprehensive surveillance is essential to minimize the misuse of medications through fraud, waste, or abuse. Systems must monitor medications coming into a health system, medications that are dispensed, and ultimately what medications are administered to the patient. Automated or manual systems should be in place to analyze receiving, dispensing, and administration transactions to identify areas of potential concern.
2) An analytics system should pull data from disparate sources and provide dashboards and applications that are easy to navigate, intuitive, and efficient, and which feature required regulatory compliance data. (Previously #6)
Description: Given the highly regulated nature of the medication-use process, software applications that monitor and measure compliance with regulations should be used.
3) Medications should contain tracking methods (barcodes, RFID, etc.) with standardized format and content. (Previously #3)
Description: Medication packaging or the process of shipping medications should have methods that support data capture for tracking distribution and transport of medications from manufacturer to the end user and all relevant points in between. Systems should enable the retrieval of specific delivery information to comply with the Drug Supply Chain Security Act.
4) All electronic devices involved in the medication-use process should have cybersecurity measures in place to prevent outside parties from gaining unauthorized access. (New)
Description: Effective cybersecurity is needed to ensure that medical device functionality, confidentiality, and integrity are maintained. While wireless, Internet- and network-connected devices have improved healthcare, their proliferation has led to greater security and patient safety risks. In addition to potentially harming the patient through incorrect drug dosing, tampering with wireless infusion pumps could expose a healthcare system to malicious attacks, leading to loss of data and services, resulting in downtime and loss of productivity. In order to ensure patient safety, measures—including encryption of wireless networks, laptops, workstations, removable storage media, and mobile devices—must be taken to prevent unauthorized parties from remotely accessing electronic devices involved in the medication dispensing process.
5) All new orders or prescriptions should include an indication. (New)
Description: To assure the appropriateness of drug therapy, an indication should be required for every order or prescription. This would directly tie to monitoring and impact outcomes associated with prescription medication use.
6) Healthcare information systems should incorporate tracking methods for all doses at all steps in the medication-use process. (Previously #4)
Description: Patient safety and outcomes are directly tied to the ability to deliver the right medication to the right patient, at the right time. This requires systems that know where a patient-specific medication is at all times.
Also, given the rising cost of therapy agents, a tracking system will allow health systems to save money by minimizing lost doses and being more accountable for these high-cost items.
7) Medication administration information should be directly retrieved from devices (IV pumps, automated dispensing cabinets, etc.) and transmitted to the electronic health record for appropriate documentation. (Previously #5)
Description: The nurse should scan the patient, scan the medication, and associate the IV pump with the medication. Information should then be sent from the electronic medication administration record to the IV pump, and the IV pump should send information back to the electronic health record once the infusion is complete, including the stop time. Finally, the nurse should validate all information in the electronic health record and complete the transaction. This process should enhance billing compliance, as most outpatient infusion requires start and stop times, and it also should help pharmacy batch IVs using real-time data.
8) Medications should be received by a person other than the one who ordered them. (New)
Description: Allowing the same individual to order and receive medications creates a step in the medication supply chain that is at risk for diversion. A system which separates and monitors these functions should be used.
9) Patients going through a care transition should be given a minimum of 24 hours of medications to support continuity of care and transition to the new pharmacy provider. (New)
Description: One of the keys to providing seamless patient care during a transition is making sure a patient’s medication therapy is uninterrupted. Interruptions of medication therapy can be caused by a variety of factors, including a patient’s inability to get to a pharmacy, unavailability of an open pharmacy, or the new care center’s pharmacy not having the appropriate medications in stock. If patients are provided a 24-hour supply of medications when discharged from one facility, the availability of the appropriate medications at the next step in their care is assured.
10) Medication purchases should be scanned upon receipt, capturing lot number and expiration dates at a minimum. (New)
Description: Scanning medications at the time of receipt provides the health system with numerous benefits:
- It ensures that the items received match the invoice from the supplier.
- It ensures that barcodes are registered in the system for use later in the distribution chain.
- It provides information that is readily available for use with recall tracking as well as providing unexpired medications to the end user.