Intelligent Hospital Pavilion HandbookRight Time
Right Dose
At The 49th ASHP Midyear Clinical Meeting & Exhibition Anaheim, CA, December 6 - 11, 2014
Right Patient
Right Patient - Right Medication Right Dose - Right Route Right Time - Right Patient - Right Medication Right Dose - Right Route Right Time Through The Use Of Technology
TM Pavilion
Intelligent Pharmacy
Produced by
ROOSEVELT UNIVERSITY COLLEGE OF PHARMACY
For more than a decade, Talyst has helped over 500 health care
systems increase productivity, enhance workflow efficiency, offer
greater inventory control and improve patient safety. Coupled
with the tremendous cost reduction capabilities available with
our 340B software and services, Talyst is your trusted partner in
engineering a safer and more cost effective pharmacy.
We are proud to be a sponsor and exhibit in the Intelligent Pharmacy™ Pavilion at booth #1777 at the ASHP Midyear Meeting. Stop by to learn more.
For more information, call 877.4.TALYST x 1 or info@talyst.com.
Visit talyst iN booth #301 at ashP Learn how we are helping health care systems across the country improve productivity, efficiency, inventory control and patient safety.
Welcome - Paul Abramowitz, CEO, ASHP - Harry Pappas, CEO & President, IHA
Welcome - Anne Olscher, COO, IHA .......................................................
The Intelligent PharmacyTM Overview By Shannon John Johnson, Pharm.D. .........................................................
The Intelligent PharmacyTM Advisory Board ................................................
The Intelligent PharmacyTM Use Cases ......................................................
Is Your Hospital Pharmacy a Strategic Asset? By Mary Baxter, MBA, R.Ph. ......................................................................
Interview with Glenn Aspenns - The Five Rights .........................................
The Internet’s Democratization of Medicine By Ashish Advani ....................................................................................
Embracing New and Emerging Technologies in Pharmacy Curricula By George E. MacKinnon III, Ph.D., R.Ph., FASHP ......................................
Diversion: Understanding and Mitigating the Risk By Kimberly New, JD, BSN, RN ..................................................................
IV Compounding: the Last Frontier of Pharmacy Automation By John Barickman, R.Ph., MBA, FACHE ....................................................
Leveraging the Power of Information - Standardizing Data in Healthcare Processes for Safer Care - By GS1 .............................................................
What is the IHA?
The Intelligent Health Association (IHA) is a global, technology based and technology focused organization comprised of many new technology communities and societies all operating under one organizational structure with a common goal: to help drive the “Evolution to the Health Revolution™ ” through the adoption and implementation of new technologies in the health Eco-system. The IHA will accomplish this goal through the delivery of vendor neutral, technology agnostic educational programs in a partnership with the other health related organizations, academic institutions, government, technology community, and standards bodies.
For further information please contact Harry P. Pappas, CEO, The Intelligent Health Association: hpappas@ihassociation.org
All rights reserved. All trademarks and copyrights in this publication are recognized, and acknowledged where possible. Any materials, written, digital, photographic and illustrative submitted are accepted on the basis of a worldwide right to publish in printed or electronic form. All contents copyright the Intelligent Health Association ©2014, and/or the respective copyright holder. No part of this document may be reproduced without written consent from the Intelligent Health Association, or the respective copyright holder, where applicable. The views expressed in this issue are those of the contributors and not ASHP or the Intelligent Health Association.
Cover design, art direction, layout, additional illustration and handbook content compilation by Andrew Neil Olscher, VP Media & Publications, The Intelligent Health Association. Individuals appear in photographs for illustrative purposes only and such appearance does not constitute an endorsement of any product, service or opinion detailed, offered or expressed within this publication, or The Intelligent PharmacyTM Pavilion.
FEATURE ARTICLES
PAGE 13
Right Patient Right Medicine Right Dose Right Route Right Time
4 4
Right Dose Right Route Right TimeRight Patient - Right Medicine
Right Dose - Right Route Right Time - Right Patient - Right Medicine Right Dose - Right Route Right Time Right Patient - Right Medicine Right Dose - Right Route Right Time - Right Patient - Right Medicine Right Dose - Right Route Right Time
M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano
Right Patient Right Medicine
at ASHP Mid-Year Meeting
M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M utoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano
Right Time
Right Route
Right Dose
Right Medicine
Right Patient
Intelligent Pharmacy TM
TABLE of CONTENTS
THE INTELLIGENT PHARMACY TM - A production of the Intelligent Health Association 2
INTELLIGENT HEALTH ASSOCIATION Healthier Living Through Technology TM
How It Works
Each item is tagged in the pharmacy or by a third party repackager prior to arriving at the hospital.
Medications are placed into kits. Each kit is placed in the scanning station for 5 seconds before and after restocking.
1
2
Kit Check shows exactly which items were used, which are nearing expiration and which need to be replaced.
Kit Check automatically generates your charge sheet and eliminates manual medication expiration recording.
3
4
Kit Check is the leader in hospital pharmacy kit automation and medication tracking software. Kit Check helps hospital pharmacists replace manual processes with faster and safer cloud-based technology solutions that are easy to implement and use.
o. 786-KIT-CHECK (786-548-2432) e. info@kitcheck.com kitcheck.com
Fast and Friendly Kit Processing
72%-90% Faster Kit Processing
99.5% Higher Kit Accuracy
$4.07 Savings per Medication
By The Numbers
Safety & Accuracy Improve pharmacy kit accuracy and increase patient safety by reducing
adverse drug event risk. Customers have improved kit accuracy from 92%
to over 99.9%.
Shortages & Recalls Manage shortages and drug substitutes centrally and know instantly
which kits are missing key medications. If there is a recall, simply enter the
NDC and lot number to locate impacted kits. Customers have cut recall
handling time by as much as 93%.
No IT Involvement You don’t have to wait for the IT department. Kit Check is a web-based
application in the cloud. It does not require any on-site servers. Simply
plug in the scanning station and use any hospital PC to securely access
the system.
PAGE 27
Is Your Pharmacy Ready for FDA’s DSCSA 2015 Implementation? By USDM ...................................................................................................
Leaders Challenge the Current Case Study - Aesynt .....................................................................................
IV Room Barcoding and Improved Pharmacy Productivity Case Study - Baxter .....................................................................................
Integrating Technology - SIGMA Spectrum Infusion System Integrates into Cerner - Case Study - Baxter ....................................................
CSTD Performance Impacts Healthcare Worker Safety Case Study - BD ..........................................................................................
Increase Use of Ready-to-Administer Prefilled Injectables Case Study - BD - By Keith P. Shuster, R.Ph., MBA .............................................
Improve Infusion Safety and Reduce Alarm Fatigue in the ICU Case Study - B Braun ....................................................................................
Forget Smart Phones - What You Need are Smart Pumps! Case Study - B Braun ...................................................................................
Smart Pumps - Achieving 100% Drug Library Compliance and Averting Medication Errors - Case Study - B Braun ......................................................
Medication Infusion Safety Through Technology and Practice Case Study - B Braun ....................................................................................
Controlling Drug Costs - Transforming the Pharmacy into a Strategic Asset Case Study - Cardinal Health ................................................................................
Changing the Standard of Care - Bedside Discharge Prescriptions Improves Patient Care - Case Study - Cardinal Health ...................................................
Wireless Interoperability Helps Optimize Intravenous Infusion Safety, Documentation and Management - Case Study - CareFusion ..........................
Best Practices in Medication Management Case Study - CareFusion ..............................................................................
Pharmacy Kit Restocking Automation Improves Efficiency and Safety Case Study - KITCHECK ..............................................................................
Electronic TLC: Toronto Hospital Increases Patient Safety With eCare Project Case Study - Motorola ................................................................................
Leaders Challenge The Current
Children’s Hospitals and Clinics of Minnesota (Children’s
Minnesota), partnering with CareFusion and Cerner,
became the first pediatric hospital system to achieve
interoperability between smart intravenous (IV) infusion
pumps and an electronic health record (EHR) system.
Children’s Minnesota is also the first hospital of any type
to implement infusion interoperability for both
large-volume and syringe IV infusions. The state’s largest
provider of neonatal, cancer, diabetes and cardiac care,
Children’s Minnesota is a nonprofit, independent pediatric
health system with 381 inpatient beds, 1,700 professional
staff, 12,218 inpatient admissions, 20,453 surgical cases,
403 active research programs and approximately $590 M in
annual revenue.
Following its successful pilot study in a PICU in March 2012,
Children’s Minnesota has implemented smart pump-EHR
interoperability for all 381 inpatient beds throughout its
Minneapolis and St. Paul hospitals, including ICUs, medical/
surgical units, short-stay units, the ER and surgical services
for acutely ill pediatric patients ranging from 400-g
neonates to 150-kg adolescents. The goal is to continually
increase medication safety while reducing costs, using
technology to help decrease costly adverse drug events
(ADEs) by 10% to 15% per year.
High-risk IV infusions present much greater medication
safety challenges than non-infusion medications.1 IV
infusion errors, which involve high-risk medications
delivered directly into a patient’s bloodstream, are the
medication errors with the greatest potential to cause
harm—especially for pediatric and neonatal patients
requiring precise weight-based dosing.2 Traditional
barcode medication administration (BCMA) systems,
PAGE 49
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013 Alerts by Drug
2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
Alerts by Drug 2013
Aborts Overrides Corrections
Reduction in alerts for target drugs: • 88% reduction in heparin ACS alerts • 88% reduction in fentanyl alerts • 48% reduction in RBC alerts • 45% reduction in dexmedetomidine
alerts • 63% reduction in propofol alerts
Overrides by Drug 2013
Compliments of:
Outlook and DoseTrac are registered trademarks of B. Braun Medical Inc. 13-3746A_4/13_BB
Objective Medication safety is a primary goal for our system of 4 major medical centers in the New York City area. To reduce errors associated with IV infusion, we evaluated several infusion pumps with smart pump technology and selected the B. Braun Outlook® 400ES based on the following key safety features:
• real time data monitoring • wireless retrospective reporting
software • ease of use • light-weight, single channel device
After implementation, we used the real time view and retrospective infusion data to identify opportunities to further enhance patient safety.
Methods A multidisciplinary team from all hospital sites met weekly to standardize our hospital formulary, including drug concentrations, diluents, and weight-based dosing. The new formulary was updated in our electronic medical record and computerized physician order entry. A smart pump drug library was created with input from various departments, establishing parameters such
as soft and hard dosing limits, clinical advisories, and bolus dosing. We created a single, uniform drug library for all smart pumps across our system.
DoseTrac® Real Time and Retrospective Data Real time monitoring allowed us to see all of our infusions, confirm whether they were programmed in the drug library, and immediately identify if any infusions were outside the dosing limits. We were pleased to find drug library utilization in critical care at 100%. Retrospective reports allowed us to identify trends with drug library utilization, dose overrides, corrections, and top drugs associated with alerts. Six month data analysis (Jan – June 2012) showed the following:
429 corrections (7%)
5,351 overrides (93%)
• Few dose corrections indicate low incidence of programming error
• Only 3 insulin corrections over 6 months!
• High number of overrides led us to look at our soft limits and practices
Alerts by Drug 2012
• 493 heparin ACS overrides - exceeding soft limit of 1000 units/hr
• 46 fentanyl “good catches”- all corrected to within the soft limits
• 396 RBCs overrides – 52% due to infusing 80-100 ml/hr (soft max 75 ml/hr)
• 198 dexmedetomidine overrides – exceeding soft limits and bolus dosing
• 250 propofol overrides – 23% due to bolus dosing
• 2988 bolus doses - using bolus feature
Results Significant reduction in alerts was achieved through dosing limit modifications, education on use of bolus feature, cheat sheet for staff, and distribution of weekly DoseTrac reports to pharmacy, nursing, and administration.
Forget Smart Phones – What You Need Are Smart Pumps! Cathy Sullivan, RN, NP, Director of Patient Care Services, Beth Israel Medical Center, New York, NY
Presented at the American Association of Critical-Care Nurses National Teaching Institute, May 2013
LEADERS CHALLENGE
THE CURRENT
About Aesynt
A customer-focused, innovative organization, Aesynt provides hospitals and health systems with high-quality, cost- effective and efficient solutions that safely deliver the right medication closest to the patient.
Founded in 1987, acquired by McKesson in 1996, and now owned by Francisco Partners, a technology-focused private equity firm, Aesynt has been a leader in pharmacy automation for more than 25 years.
At Aesynt, we understand hospitals and health systems are facing complex issues. Helping solve those challenges is our top priority. Our sole focus is on helping health care providers meet their biggest challenges – delivering quality care, reducing costs and operating more efficiently.
As a market leader in pharmacy automation and medication management, we know the health care industry inside and out, and understand how the evolving health care landscape affects you and your business.
We were the first company to offer a robotic, barcode- based solution for medication dispensing, and we now boast an integrated flexible portfolio of solutions to address every stage of medication delivery, whether in a single hospital or across multiple facilities, and regardless of medication type.
Through automation and information management, we provide an enterprise solution that offers visibility, control and flexibility into how you buy, store, package, compound, track and deliver medication, from high- volume, unit-dose oral solids to high-risk, high cost injectable medications across the medication supply chain.
TMAesynt is pleased to sponsor the Intelligent Pharmacy Pavilion and the
Aesynt Leadership Theater at the 2014 ASHP Midyear Clinical Meeting & Exhibition
Solving Complex Medication Management Challenges for Health Systems
CONT’D
Right Dose Right Route Right TimeRight Patient - Right Medicine
Right Dose - Right Route Right Time - Right Patient - Right Medicine Right Dose - Right Route Right Time Right Patient - Right Medicine Right Dose - Right Route Right Time - Right Patient - Right Medicine Right Dose - Right Route Right Time
M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano
Right Patient Right Medicine
at ASHP Mid-Year Meeting
M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M utoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano
Right Time
Right Route
Right Dose
Right Medicine
Right Patient
Intelligent Pharmacy TM
A production of the Intelligent Health Association 4THE INTELLIGENT PHARMACY TM -
Welcome From Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP CEO, ASHP
Welcome to the ASHP Midyear Clinical Meeting and the first-ever Intelligent Pharmacy Pavilion (IPP).
We are excited to host this innovative exhibit that will provide you with a unique look at the ways that technology can be utilized to prevent errors and improve safety for your patients.
This 8,000 square-foot pavilion features demonstration rooms showcasing the latest technologies utilized in today’s hospitals and ambulatory care clinics. The IPP will give you a chance to observe the integration of medication management technology and patient care delivery.
The Midyear, the world’s largest gathering of pharmacists, is the perfect setting for the IPP. I encourage you to take advantage of the exceptional educational programming and dynamic networking opportunities that the meeting offers. Use the program book or the ASHP Live meeting app to help you navigate everything happening this week.
Thank you for joining us at the Midyear. Enjoy your interactive tour of the Intelligent Pharmacy Pavilion!
The senior management of the Intelligent Health Association (IHA) (www.ihassociation.org), the senior executives of the ASHP organization, along with our many supporting technology sponsors welcome you to the launch of this destination pavilion: “The Intelligent Pharmacy” Pavilion at ASHP 2014.
As the Founder and CEO of the Intelligent Health Association (IHA), I am very pleased to welcome you to ASHP’s newest educational, technology centric, destination pavilion: the “Intelligent Pharmacy” Pavilion.
The IHA is an international, educational, vendor neutral, technology centric association dedicated to promoting, through educational programs, the adoption of new technologies in the health community for the improvement of patient care and patient safety through the use of technologies.
You may already know our organization, the Intelligent Health Association (IHA), as the developer of a similar, very successful, destination pavilion: The “Intelligent Hospital Pavilion” and the “Intelligent Medical Home” pavilion that we produce and present at the annual www.HIMSS.org trade show and conference. Visit: www.intelligenthospital.tv and view our many videos.
I would like to acknowledge and thank, my friend and industry thought leader, Dr. John Johnson, of Sharp Memorial Hospital, San Diego, CA for serving as the chairman of the steering committee and for developing and guiding all aspects of the “Intelligent Pharmacy” Pavilion. Along with Dr. Johnson, I would also like to thank his team of industry leaders, deans and academicians from a number of schools of pharmacy, the FDA, State Board of Pharmacies and his group of progressive thinking technology vendors. We all are grateful to Dr. Johnson for giving his time and for helping educate his colleagues. Dr. Johnson and his team are bringing great change to the hospital pharmacy community, while at the same time helping to improve patients’ lives through the adoption of new technologies in the hospital pharmacy. He is part of the “Evolution to the Healthcare Revolution”™.
I also thank the ASHP leadership for their vision in working with the IHA team to create this educational “Intelligent Health- System Pharmacy” Pavilion.
If you would like to join our educational team for ASHP 2015 and to assist us in planning future educational programs, please let us know by dropping me a note at: hpappas@ihassociation.org
Thank you for visiting and touring YOUR “Intelligent Pharmacy” Pavilion.
INTELLIGENT HEALTH ASSOCIATION Healthier Living Through Technology TM
Welcome From Harry P. Pappas Founder and CEO of the Intelligent Health Association
5 A production of the Intelligent Health Association THE INTELLIGENT PHARMACY TM -
As COO of the Intelligent Health Association, I’m delighted to welcome you to the launch of the Intelligent Pharmacy Pavilion (IPP) at the ASHP Midyear Clinical Meeting. The IPP is the result of close partnerships with pharmacists, nurses, administrators and industry to showcase how existing and emerging technologies can be combined and integrated most effectively in the real world.
Our goal is to help raise the level of awareness of technologies that make healthcare more efficient, effective and comprehensive via wireless information delivery, as well as medical devices, wireless sensors applications and Auto-ID RFID/RTLS platforms. The integrated technology and solutions displayed and demonstrated at the pavilion are designed not only to improve patient care in the hospital, but to assure the wellness of that patient even after he, or she, goes home.
The pavilion will provide demonstrations of diverse technologies and systems, and show how they can be integrated through a series of use case demonstrations, highlighting the impact in workflows, patient care and data sharing between the central or facility pharmacy and the healthcare provider. The tours will incorporate a variety of use cases which demonstrate how technology helps ensure that the correct medication and dose gets to the right patient, at the right time and via the right route.
In addition to tours, we have an exciting line-up of speakers in the Aesynt Leadership Theater, with sessions running every 20 minutes during exhibit hall hours. In keeping with our mission to continue delivering educational programs, as well as to sponsor research and collaborate with standards bodies to ensure technologies provide the benefits most needed in the healthcare community, we have partnered with three universities. Representatives will be present in our pavilion, fielding questions on their schools of pharmacy.
Please plan to stop by our pavilion.
INTELLIGENT HEALTH ASSOCIATION Healthier Living Through Technology TM
Welcome From Anne Olscher COO, The Intelligent Health Association
Come see us at ASHP booth #1101
BD Pharmacy Solutions Pharmacy solutions now... for healthcare’s tomorrow.
BD and BD Logo are trademarks of Becton, Dickinson and Company. © 2014 BD MSS0639a (10/14)
BD Medical 1 Becton Drive Franklin Lakes, NJ 07417 www.bd.com
What’s the secret to surviving in healthcare? Always knowing your next move. There’s no doubt—healthcare is evolving into an entirely different game. More and more, you’ll be tasked to improve quality, while keeping costs under control. Does that seem like a losing battle? Not if you have the right strategy and partner. BD Pharmacy Solutions is on the front lines with you. Because in a changing game, your next move is more important than ever.
Innovative solutions for: • Patient and healthcare worker safety • Workflow efficiency • Cost containment
14-BEC00-02-0004_ASHP JournalAd_CHESS-8x5.125.indd 1 10/15/14 10:12 AM
A production of the Intelligent Health Association 8
THE INTELLIGENT PHARMACY™ Overview A production of the Intelligent Health Association - a not-for-profit, educational organization
Shannon “JJ” Johnson, Pharm.D. Director of Pharmacy, Intelligent Health Association
Welcome to the first ever Intelligent Pharmacy Pavilion at an ASHP meeting. The pavilion we’ve built for you includes two full-size pharmacies and a nursing unit, similar to the ones you all probably work in every day. As every health-system pharmacist knows, complex systems contribute to human errors and pharmacy is only getting more complex by the day. Medication misadventures happen at any number of critical steps in the delivery of care. In the Intelligent Pharmacy at the ASHP Midyear Clinical Meeting you will see examples of these challenges combined with interesting and innovative solutions. Some of these solutions will be emerging technologies geared to increase patient safety and operational efficiencies. Others will focus on improving the pharmaceutical supply chain from ordering all the way to the patient’s bedside. Tour participants will watch and listen as live pharmacist and pharmacy technician actors perform their daily duties while interacting with various technologies that help them to be more efficient and accurate at every stage of the medication use process.
While this method of showing medication-use related technology in action with real live actors in a fully built out pharmacy is new to ASHP, it’s not new to the industry. It actually began about four years ago at the Health Information Management Systems Society (HIMSS) annual meeting and just two years ago we launched our first pharmacy demonstration. It was such a success we’re fortunate to have been given the opportunity to bring it to the ASHP Midyear Clinical Meeting this year, albeit with a special new twist. While we’re showing the traditional hospital or “facility” pharmacy you would see in any hospital, we’ve also added a “central” pharmacy. Known also as a “hub-and-spoke” model, the central pharmacy is designed to support many facility-based pharmacies throughout a health-system. This model is becoming more common these days as health-systems realize the advantage of aggregating some services together while reducing duplicate inventory at each facility.
We invite you to tour the pavilion and see real solutions to current problems health-system pharmacists face every day. We hope it will spark an idea or a thought in your mind on how to solve a problem you might be facing.
Dr. Shannon “JJ” Johnson is Director of Pharmacy for Sharp Memorial Hospital in San Diego, California. Sharp Memorial is a level 2 trauma center with over 380 staffed acute care beds and is one of 7 hospitals within the Sharp system. Dr. Johnson leads a team of over 70 of the best pharmacists and pharmacy technicians in San Diego that promotes safety and safe medication use as one of their core pillars of excellence. Sharp is also recognized by Hospitals & Health Networks Magazine’s 2013 Most Wired, and was a 2007 Malcolm Baldrige National Quality Award winner.
INTELLIGENT HEALTH ASSOCIATION Healthier Living Through Technology TM
Intelligent Pharmacy Pavilion Advisory Board and Steering Committee
John Johnson, Pharm.D. - Chairman - Director of Pharmacy, Sharp Memorial Hospital, San Diego
Anne Olscher - Co-Chair - COO, The Intelligent Health Association
Chris Chandler, Pharm.D. - Co-Chair - VP of Healthcare Solutions and Services at USDM Life Sciences
Harry P. Pappas - Founder and CEO of the Intelligent Health Association
Paul Frisch, PH.D. - Chief, Biomedical Physics and Engineering Service,
Memorial Sloan Kettering Cancer Center, New York
George McKinnon III, Ph.D., R.Ph, FASHP - Founding Dean and Professor College of Pharmacy,
Vice Provost Health Sciences, Roosevelt University, Schaumburg, IL
Troy Reiff, RN - COO, RFID in Healthcare Consortium
Ashish Advani, Pharm.D., R.Ph., Pharmacist and Assistant Professor,
Mercer University College of Pharmacy, Atlanta, GA
THE INTELLIGENT PHARMACY TM -
Right Patient Right Medicine
Right Dose Right Route Right TimeRight Patient - Right Medicine
Right Dose - Right Route Right Time - Right Patient - Right Medicine Right Dose - Right Route Right Time Right Patient - Right Medicine Right Dose - Right Route Right Time - Right Patient - Right Medicine Right Dose - Right Route Right Time
M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano
Right Patient Right Medicine
at ASHP Mid-Year Meeting
M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M utoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano NFC M2M AutoID RFID BLE RTLS Wireless Sensors BLE Biometrics M2M AutoID RFID RTLS Wireless Nano M2M AutoID RFID BLE RTLS Wireless Sensors Biometrics M2M AutoID RFID RTLS Wireless Nano
Right Time
Right Route
Right Dose
Right Medicine
Right Patient
Central Pharmacy/Supply Chain Room - Hub-And-Spoke Pharmacy Supply Chain Model
Omnicell: Central Pharmacy Manager Requested items from within the entire healthcare system populate the prioritized picking queue, and then guide the pharmacy tech to pick those items. Once all the items are picked, those items are delivered to the appropriate location.
Talyst: AutoVault Mini w/AutoCool i.H With your AutoPharm® Enterprise inventory system, AutoVault w/AutoCool provides secure access to medications (including controls and refrigerated medications) in central pharmacies, remote pharmacies, satellite pharmacies, outpatient clinics, and specialty clinics and fully integrates the transaction data for streamlined reporting and ordering.
Central Pharmacy Compounding Lab
AESYNT: i.v.SOFT®
i.v.SOFT® is a family of software solutions that bring the benefits of automation to manual compounding and dispensing. i.v.SOFT increases medication safety with enhanced dosage and diluent accuracy, while improving the quality and efficiency of IV workflow.
B. Braun Medical Inc.: Computerized Physician Order Entry of Parenteral Nutrition Orders Pinnacle TPN Manager is the only CPOE and Pharmacy software with Trissel’s Calcium-Phosphate Safety Check. It automates calculations to streamline the prescribing of parenteral nutrition from order entry to infusion from physician to patient.
Baxter Healthcare: DoseEdge Pharmacy Workflow Manager: Complete Pharmacy Workflow Solution The DoseEdge System is an enterprise solution that manages the workflow for dose routing, preparation, inspection, tracking and reporting on IV and oral liquid doses. By providing visibility to the entire dose preparation and dispensing process for both patient- specific and stock doses, the DoseEdge System helps promote dose preparation safety, reduce waste and enhance pharmacy productivity.
Facility Pharmacy - Traditional Inpatient Pharmacy
Kit Check: Medication Kit and Tray Vending and Deployment Kit Check drives efficiency and patient safety improvements in hospital pharmacies by automating the slow, manual, error-prone kit replenishment process and eliminating kit medication errors. Our flexible software efficiently manages drug shortages, recalls and expiring medications.
Talyst: AutoPharm Enterprise w/AutoCarousel Mini AutoPharm® Enterprise, a powerful software platform, provides enterprise-wide medication management across your entire health system to offer greater inventory control, enhanced workflow efficiency, and improved patient safety. AutoCarousel® Mini provides secure, automated storage for all your medications. This demonstrates the concept of high density automated storage as well the specific Mini product which is perfect for compact spaces.
CareFusion: Track and Deliver “Where’s my med?” – the most common question Nursing asks Pharmacy. By providing visibility for all medications in transport from Pharmacy to the Nursing unit, Pyxis® ES Link Track and Deliver can help improve communication, enhance nursing efficiency and reduce medication waste.
Intelligent PharmacyTM
USE CASES
9 A production of the Intelligent Health Association THE INTELLIGENT PHARMACY TM -
Cardinal Health: Remote Pharmacy Services
From the pioneers in Remote Pharmacy Services. With Cardinal Health Remote Order Entry Service, you can ensure every medication order is thoroughly reviewed by a hospital-trained pharmacist - any time, day or night to ensure continuity of care.
Cardinal Health: Drug Cost Opportunity Analytics Drug Cost Opportunity Analytics is a web-based dashboard that helps pharmacy leaders identify pharmacy drug cost and use drivers, outlier performance, cost savings opportunities and improve forecasting capabilities, as well as benchmark performance.
Baxter Healthcare: ICNet Relevant information. Continual monitoring. Quality-of-care metrics. ICNet clinical surveillance software provides you the insight to make more informed decisions on medication usage and infection prevention measures. Come see the power and flexibility of this tool.
PharmView: Real Time Status View of IVs for Pharmacy IV Admixture Services
PharmView provides visibility to infusion data in real-time. With updates every 3 seconds, schedule your preparations based on actual time due, minimizing urgent requests and waste. Data fields and alerts are fully customizable.
Compounding Lab In The Facility Pharmacy BD: BD Cato Medication Workflow Solutions
BD Cato™ Medication Workflow Solutions is an innovative gravimetric-based, barcode verification-enabled workflow solution that enhances safety and workflow efficiency of preparation of IV medications by detecting wrong drug and wrong dose errors in real time.
BD: BD PhaSeal Closed System Drug Transfer Device BD PhaSeal™ Closed System Drug Transfer Device (CSTD) is proven to reduce healthcare workers’ exposure to hazardous parenteral medications from preparation in the pharmacy to administration with the patient to disposal. The BD PhaSeal System is an airtight and leak-proof CSTD that mechanically prohibits the transfer of environmental contaminants into the system and the escape of drug or vapor concentrations outside the system, thereby minimizing individual and environmental exposure to drug vapor aerosols and spills.
Nursing Area/ Acute Care Adult Omnicell: Remote Med Selection and Automated Dispensing Cabinet (ADC) Med Removal Nurse at bedside pain assessment, request pain meds remotely, pain meds removed from ADC, transport back to bedside in mobile medication cart.
BD: BD Simplist Ready-to-Administer Prefilled Syringes BD Simplist™ ready-to-administer pre-filled injectables supplied by BD Rx from its state-of-the-art pharmaceutical plant are designed to improve patient care and safety by decreasing the number of steps in the traditional vial and syringe injection sequence, reducing the potential risk of medication error.
B. Braun Medical, Inc: Break Out of the Pharmacy! DoseTrac® - Real Time View for Error Prevention
B.Braun’s DoseTrac® Software displays all of your infusions – in real time -giving you instant visibility to improve safety and enabling our clients to achieve 100% library compliance, 88% alarm reduction and 0 ADEs.
Baxter Healthcare: SIGMA Spectrum Pump Today, we will walk you through our pump programming workflow and demonstrate the ease of use and the safety features built into this pump. We will also highlight safety features that are unique to our system. We are in a Critical Care unit and we are going to start an infusion order to start Dobutamine infusion on a patient.
Nursing Area/ Acute Care Pediatric
B. Braun Medical Inc.: Computerized Physician Order Entry of Parenteral Nutrition Orders Pinnacle TPN Manager is the only CPOE and Pharmacy software with Trissel’s Calcium-Phosphate Safety Check. It automates calculations to streamline the prescribing of parenteral nutrition from order entry to infusion from physician to patient.
A production of the Intelligent Health Association 10THE INTELLIGENT PHARMACY TM -
CareFusion: Med Labeling
Medication safety is enhanced when a barcoded label from the Pyxis MedStation® ES system makes a generic medication patient-specific. With an additional scan of the Alaris® system at the bedside, closed-loop infusion safety is enabled between the computerized physician order entry (CPOE) and the Alaris system. This interoperability enables pre-population of infusion order parameters from the electronic medical record (EMR) and wirelessly sends infusion status to the EMR in near real time to simplify documentation verification and sign-off.
Nursing Area/ Outpatient
CareFusion: Rowa Vmax With Rowa Visavia
The Rowa Vmax system streamlines medication management by automating stock intake, recording expiry dates and batch numbers, and providing storage and picking of orders, helping make hospital workflow more efficient. With the Rowa Visavia terminal, patients can pick up pre-ordered medications with 24/7 service and consultation - transparent, quick and safe.
BD: BD PhaSeal Closed System Drug Transfer Device
BD PhaSeal™ Closed System Drug Transfer Device (CSTD) is proven to reduce healthcare workers’ exposure to hazardous parenteral medications from preparation in the pharmacy to administration with the patient to disposal. The BD PhaSeal System is an airtight and leak-proof CSTD that mechanically prohibits the transfer of environmental contaminants into the system and the escape of drug or vapor concentrations outside the system, thereby minimizing individual and environmental exposure to drug vapor aerosols and spills.
Cardinal Health: Outpatient Pharmacy Solutions With Bedside Medication Delivery Outpatient Pharmacy Solutions enables pharmacists to play a critical role in continuing patient care, by ensuring patients receive and understand their medications before they leave the hospital, while simultaneously driving revenue and lowering employee benefit costs.
Take on Tomorrow. Visit us at ASHP Booth #589
Facing the reality of empty promises?
Omnicell was ranked Best in KLAS for Automated Medication Dispensing Units from 2010 – 2014. Best in KLAS Awards – Medical Equipment & Infrastructure Reports, 2006-2014. ©2014 KLAS Enterprises LLC. All rights reserved. www.KLASresearch.com
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Rx A ss
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The pharmacy is not often an optimized asset in the hospital. In fact, it is often viewed simply as a utility or cost center. The time has come for that to change, and the sooner the better.
Dramatic changes underway in healthcare - from the Affordable Care Act to the sheer imperative to cut costs and improve performance - are forcing hospital administrators to rethink how their hospitals are leveraging resources and teams to achieve their strategic agendas. For example, the old-fashioned way of seeing a hospital pharmacy - as a break-even or marginally profitable order-filling service department - can’t be sustained in today’s competitive healthcare environment.
So what does it mean to leverage the hospital pharmacy as a strategic asset? In short, a pharmacy should be expected to add value to every aspect of a hospital’s strategic agenda. It can, and should, contribute substantially to grow revenue, improve efficiency, reduce waste, improve patient outcomes and create a competitive advantage.
Exponential benefits - both financial and in quality of care - are possible, especially when compared to departments and functions that have not previously been optimized.
To transform the pharmacy into a strategic asset, hospitals don’t have to reinvent the wheel. Many of the tools and resources exist, yet are not being strategically implemented. First and foremost, it requires executive sponsorship beyond the walls of the pharmacy, and a multi- disciplinary team of care providers to be aligned and to execute on strategic initiatives. This team would include administration, physicians, nurses, and the pharmacy leadership.
It also requires program management, with the development of scorecards and key performance indicators. Lastly, it requires pharmacy leadership that is engaged in key initiatives, committees and teams across the hospi