When it comes to healthcare and providing quality medical services, it is important to be efficient without sacrificing quality.
The NARMC Pharmacy has adapted its processes with the goal of efficiency in mind.
“We simply focused on areas where we could make an impact and efficiency followed. With medication reconciliation, also known as med rec, for example, taking medication histories from our patients is an area where we have a lot of experience. By helping with this process, we are able to save our nurses a significant amount of time,” Drew Jensen, PharmD, said.
The Pharmacy team began focusing on patients’ medication histories and found that developing those lists was something that improved efficiency and quality of care.
Med rec is the process of compiling the most complete and accurate list of medications that a patient takes at home. The team found that this process takes about 22 minutes per patient on average.
“When you think about how many patients visit the ER every day, this time adds up quickly. So, one of the major benefits of pharmacy-led med rec is that our nursing staff is able to spend more time on direct patient care activities - improving quality of care for our patients - while we are able to focus on the medications, which improves safety,” Jensen added.
By making sure a medication list is up to date and accurate, the staff can make sure patients are not given medications that interact with each other or given too much of a particular prescription. Safety is the driving motivation for this project. Since starting the Med rec program in April 2017, more than 3,000 med recs have been completed. A total of 22,282 discrepancies were found and resolved which resulted in 46 days worth of time savings and $1.6 million in monetary savings.
When the Claude Parrish Cancer Center began offering chemotherapy, the team found that there was an opportunity to improve efficiency.
“One of the challenges we faced when we started was to incorporate new processes into our existing workflow, especially more advanced sterile compounding. For instance, the preparation step for certain agents used in oncology can be quite lengthy and require up to 30 minutes to prepare a single dose. We apply the same checks to chemotherapy as we do to all meds: right patient, right drug, right dose, right time and right route,” Jensen said.
The team organized the room where the chemo medications are put together in a way that helps the pharmacists compound each medication efficiently. Since chemotherapy medications are prepared right before being infused, it is crucial to have everything in place so that patients can get the care they need as soon as they need it.
On average, prior to focusing on efficiency, it took someone 20 to 30 minutes to compound chemotherapy. Now, it takes the team anywhere from 12-19 minutes. Every minute counts when it comes to providing quality care.
“Pharmacy is a field that is constantly changing, and we are also involved in many areas of patient care. In addition to med rec and chemotherapy, we have pharmacists involved in diabetes treatment, clinical informatics, and antibiotic monitoring, to name a few,” Jensen added. “We are constantly looking to see how our involvement can improve efficiency not only in the pharmacy, but across the hospital. As in any work environment, we face obstacles, but we work together as a team to get past them. We also exchange ideas freely and value each other’s opinions, which have been driving forces behind our efforts to improve efficiency.